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55  a 

HEALTH  SCIENCES  LIBRARY 
OF  THE 

UNIVERSITY  OF  NORTH  CAROLINA 
AT  CHAPEL  HILL 


WC 

588 

J77 

188U 


JUL  2  1 

This  book  circulates  for  a  2-week  period  and  is 
due  on  the  last  date  stamped  below.  It  must  be 
brought  to  the  library  to  be  renewed. 

\r 

Form  No.  77 1 

Digitized  by  the  Internet  Archive 
in  2020  with  funding  from 
University  of  North  Carolina  at  Chapel  Hill 


https://archive.org/details/contagiousinfectOOjone 


CONTAGIOUS  AND  INFEGTIOUS,DIS?ASES, 


Orn  cu> 


1 


MEASURES  FOR  THtoRPENTION  IM-ARREST. 


/m 


SMALL  POX  (VARIOLA) ;  MODIFIED  SMALL  POX 
(VARIOLOID);  CHICKEX  POX  (  VARICELLA  ); 
COW  POX  (VARIOLAS  VACCIXAAB) ; 


VAOCI1TATIOIN', 

SPURIOUS  VACCINATION. 


ILLUSTBATED  BY  EIG-HTT  COLORED  PLATES. 


CIRCULAR  No.  2, 

PREPARED  FOR  THE  GUIDANCE  OF  THE  QUARANTINE  OFFI¬ 
CERS  AND  SANITARY  INSPECTORS  OF  THE  BOARD  OF 
HEALTH  OF  THE  STATE  OF  LOUISIANA. 

BY  JOSEPH  JONES,  M.  D.,  ' 

PRESIDENT  01  THE  BOARD  OF  HEALTH  OF  THE  STATE  OF  LOUISIANA. 


(EXTRACT  FROM  THE  REPORT  OF  THE  HOARD  OF  HEALTH  TO  THE  GENERAL  ASSEMBLY 

OF  LOUISIANA,  1883,  1884. 


BATON  ROUGE: 

PRINTED  BY  LEON  J  A  STREW  SKI .  STATE  PRINTER 

1884. 


OF  THE 


O’ 


(  Office,  36  Dryades  street. 

JOSEPH  JONES,  M.  D.,  President  •’  Residence,  156  Washington  street, 

(  cor  Camp,  Fourth  District. 


I.  N.  MARKS,  Esq., 

EDWARD  BOOTH,  Esq., 

A.  W.  BOSWORTH,  Esq., 

J.  C.  FAGET,  D.  M.  P.,  *  - 
CHARLES  E.  KELLS,  D.  D.  S., 
FELIX  FORMENTO,  M.  D., 
GEORGE  K.  PRATT,  M.  D.,  - 

4 

L.  H.  YON  GOHREN,  M.  D., 


1  Office,  33  Camp  street. 

(  Residence,  163  Annunciation  street. 

|  Office,  32  Magazine  street. 

(  Residence,  506  Magazine  street. 

Office,  29  Natchez  street. 

Residence,  152  Washington  street. 

j  Office  and  Residence,  281  North  Ram- 
i  part  street. 

(  Office  and  Residence,  12  Dauphine 
i  street. 

I  Office,  7  Baronne  street. 

I  Residence,  81  Esplanade  street. 

{  Office,  130  Canal  street.  . 
j  Residence,  Prytania  and  Urania  sts. 

f  Office,  219  Canal  street, 
i  Residence,  726  Dauphine  street. 


STANDING  COMMITTEES  BOARD  OF  HEALTH. 

Finance — Messrs.  Marks,  Booth  and  Bosworth. 

Sewerage ,  Drainage ,  Sanitary  Apparatus ,  Cemeteries,  Slaughterhouses ,  etc. _ 

Messrs.  Booth,  Kells,  Yon  Gohren,  Faget  and  Bosworth. 

Conference — Messrs.  Bosworth,  Pratt,  Faget,  Marks  and  Booth. 
Adulteration  of  Food ,  Medicines,  Poisons  and  Impurities  of  Water — Messrs. 
Formento,  Kells  and  Yon  Gohren. 

Inspectors 3  Reports — Messrs.  Pratt,  Booth  and  Formento. 

Infectious  and  Contagious  Diseases — Messrs.  Faget,  Pratt  and  Formento. 
Legislation — Messis.  Jones,  Marks,  Booth  and  Pratt. 

Registration  of  Physicians — Messrs.  Pratt,  Faget  and  Yon  Gohren. 


PREFACE. 


The  prevalence  of  small-pox  in  the  States  tributary  to  the  Mississippi 
river,  and  the  constant  danger  to  which  Louisiana  is  exposed  from  her 
geographical  position,  and  from  the  peculiar  race  conditions  of  the  lower 
sections  of  the  Mississippi  valley,  as  well  as  the  neglect  of  vaccination  by 
large  masses  of  the  population,  and  the  growth  of  a  sentiment  opposed 
to  vaccination,  on  the  part  of  the  profession  and  people,  have  rendered 
this  work  necessary. 

No  more  important  subject  can  engage  the  attention  of  the  medical  pro¬ 
fession  and  sanitary  authorities,  and  of  the  representatives  of  the  State 
municipal  and  parish  governments,  than  the  prevention  of  small-pox. 

Vaccination  and  all  that  relates  to  vaccination,  is  of  paramount  impor¬ 
tance  to  the  health  and  material  welfare  of  the  inhabitants  of  Louisiana. 

JOSEPH  JONES, M.  D. 

No.  156  Washington  street,  Fourth  District,  New  Orleans,  La.,  1884. 


7707  / 


CONTENTS. 


Contagious  and  Infectious  Diseases,  measures  for  their  prevention  and  arrest  by 

Joseph  Jones,  M.  D .  . . 

Vaccination — Variola)  Vacointe  (Cow-pox) ;  Variola  and  Varioloid;  Accidents 

Attending  Vaccination  ;  Spurious  Vaccination  . 

Circular  No.  2 — Prepared  for  the  guidance  of  the  Quarantine  Officers  and  Sani¬ 
tary  Inspectors  of  the  Board  of  Health  of  Louisiana,  by  Joseph  Jones,  M.  D. 

Compulsory  Vaccination . 

Ordinance  relative  to  Compulsory  Vaccination . . 

Extract  from  the  Proceedings  of  the  Meetings  of  the  Board  of  Health,  State  of 

Louisiana,  September  6,  1883,  relative  to  Small-pox  and  Vaccination  . 

Mortality  from  Small-pox  during  the  first  eight  months  of  1883,  in  New  Orleans, 

Louisiana . . 

Letter  of  President  of  the  Board  of  Health  to  Mayor  of  New  Orleans . 

Causes  of  the  popular  opposition  to  Vaccination . 

Works  of  Edward  Jenner . 

An  Inquiry  in  the  Causes  and  Effects  of  the  Variola)  Vaccinse  Disease,  discov¬ 
ered  in  some  of  the  Western  Counties  of  England,  particularly  Gloucester¬ 
shire,  and  known  by  the  name  of  the  cow-pox,  by  Edward  Jenner,  M.  D.  E. 

R.  S.  Third  edition,  London,  1801...  . 

Further  Observation  on  the  Variola)  Vaccin®,  by  Edward  Jenner . 

A  Continuation  of  Facts  and  Observations  relative  to  the  Variol®  Vaccin®  or 

Cow-pox,  by  Edward  Jenner,  M.  D.,  I'1.  R.  S.,  etc.,  London,  1801 . 

Dr.  Jenner’s  Account  of  the  Origin  of  the  Vaccine  Inoculation. . . 

Dr.  Jenner’s  Instructions  for  Vaccine  Inoculation . . . 

An  Inquiry  Concerning  the  History  of  the  Cow-pox,  principally  with  a  view  to 
supercede  aud  extinguish  the  small-pox,  by  George  Pearson,  M.  D.,  F.  R.  S., 
Physician  to  St.  George’s  Hospital,  of  the  College  of  Physicians,  London, 

1798 . . . . . 

Reports  of  a  Series  of  Inoculations  for  the  Variola)  Vaccina),  or  Cow-pox;  Re¬ 
marks  and  Observations  on  this  Disease  considered  as  a  substitute  for  the 
Small-pox,  by  William  Woodville,  M.  D.,  Physician  to  the  Small-pox  and  In¬ 
oculation  Hospitals,  London,  1799 . 

The  Errors  of  Drs.  Woodville  and  Pearson  arose  from  the  performance  of  Cow- 
pox  Inoculation  in  an  atmosphere  poisoned  by  the  contagious  emanations  of 

small-pox.  Correction  of  the  errors  of  Dr.  Woodville  by  Dr.  Jenuer . 

Experiments  of  Dr.  Robert  Willan  in  the  years  1799  and  1800,  on  the  combined 

inoculation  of  the  Variolous  and  Vaccine  lluids . 

References  illustrating  the  extensive  nature  of  the  contributions  by  various 
observers  to  the  literature  of  cow-pox  inoculation,  during  the"  first  five 

years  after  Jenner’s  announcement  of  his  discovery . 

Report  of  the  Royal  College  of  Physicians  of  London  on  Vaccination,  with  an 
appendix  containing  the  opinions  of  the  Royal  College  of  Physicians  of 
Edinburgh  and  Dublin  ;  and  of  the  Royal  College  of  Surgeons  of  London, 

of  Dubliu,  and  of  Edinburgh . . . 

The  occurrence  of  Small-pox  after  Vaccination,  excited  in  the  minds  of  some 

distrust  as  to  the  protective  power  of  Cow  pox  inoculation . . 

Dr.  Jenner  referred  the  reported  failures  of  Vaccination  to  several  causes . 

Epidemic  Small-pox  of  1818 . . . . 

Hostility  Arroused  Against  Vaccination . . . 

Investigations  of  Dr.  Alexander  Monro  on  Small-pox  and  Vaccination  . 

Mr.  Bryce, s  Test. . . .  . 

Opinion  of  the  Medical  Profession  in  1818,  as  to  the  protective  power  of  Vaccina¬ 
tion  against  Small-pox .  . .  . 

Dr.  Thomson’s  Theory  of  the  Ideutity  of  Chicken-pox  and  Modified  Small-pox.. 

Establishment  of  Revaccinatiou  . . . 

Professional  Views  held  in  1839,  as  to  correct  vaccination  and  impediments 

thereto . . 

History  of  Small-pox  Inoculation.*.. .  ...  . 

Comparative  Advantages  of  the  Inoculated  Small-pox  and  of  the  Cow-pox" 

Mortality  Occasioned  by  Inoculated  Small-pox . . ’  ’ "  ’ 

The  Practice  of  Inoculation  for  the  Small-pox,  substituted  a  comparatively  miid 
form  of  the  disease,  attended  with  but  small  mortality;  but  the  total  num¬ 
ber  of  deaths  by  small-pox  was  thereby  increased,  and  the  perpetuation  and 
spread  of  this  loathsome  pestilence  on  the  surface  of  the  earth  was  promoted 

by  inoculation . . . 

The  Mortuary  Statistics  of  London  demonstrated  that  inoculation  actually  in¬ 
creased  the  mortality  from  small-poX  * . . . c . . . .  y _ 


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153 


CONTENTS. 


v. 


PAGE. 

The  Advantages  of  Cow-pox  Inoculation  demonstrated  by  official  records  and 

statistics.. . 154 

Mortuary  Records  of  London . 155 

Mortuary  Records  of  England . . . . .  156-158 

Mortality  by  Small-pox  in  Copenhagen  for  a  period  of  100  years  before  vaccina¬ 
tion  and  during  vaccination . 159 

Death  rate  from  Small-pox  in  various  countries  before  and  subsequent  to  vac¬ 
cination . 160 

Outline  of  the  introduction  of  Cow-pox  Inoculation  in  various  countries .  164 

History  of  Cow-pox  Inoculation  in  England . . .  164 

History  of  Cow-pox  in  Ireland . . . 167 

History  of  Cow-pox  in  the  Duchies  of  Schleswig  and  Holstien . .  168 

Cow-pox  in  Germany . 174 

Cow-pox  in  France . _ .  175 

Observations  of  Bosquet  on  the  cow-pox  discovered  at  Passy,  near  Paris,  in  1836.  175 

Comparison  by  Bosquet  of  the  Phenomera  of  the  old  and  new  vaccine .  176 

Discovery  of  Cow-pox  in  America . . . .  _ .  .  178 

Introduction  of  Vaccination  into  United  States  of  America _ ' .  180 

Introduction  of  Vaccination  into  the  New  England  States,  more  especially  into 

Boston,  Massachusetts,  by  Dr.  Waterhouse... . . . .  180 

Letter  of  Mr.  Jefferson  to  Dr.  Jenner . . . .  181 

Letter  of  John  Quincy  Adams  to  Dr.  Jenner .  182 

Introduction  of  Vaccination  into  the  Southern  States  by  Thomas  Jefferson,  of 

Virginia . 183 

Correspondence  between  Thomas  Jefferson  and  Dr.  Benjamin  Waterhouse,  of 

Cambridge,  Massachusetts,  with  reference  to  Vaccination . . .  184-190 

Introduction  of  Vaccination  into  New  York,  United  States  of  America .  191 

Total  Deaths  from  All  Causes,  and  from  Small-pox,  Measles,  Scarlet-fever  and 
Phthisis- pulmonalis  in  the  city  of  New  York  during  a  period  of  fifty  years, 

from  1804  to  1853 . 193 

Introduction  of  Vaccination  into  Philadelphia,  Pennsylvania . .  194 

Deaths  from  Small-pox  in  Philadelphia  from  1807  to  1882,  inclusive .  195 

Mortuary  Statistics  of  Philadelphia . 196 

Small-pox  and  the  Introduction  of  Vaccination  in  South  Carolina . .  197 

Deaths  in  Charleston,  South  Carolina,  from  All  Causes  and  from  Small-pox,  1822- 

1848,  inclusive . 202 

Deaths  in  Charleston,  South  Carolina,  from  All  Causes  and  from  Small-pox,  1844- 

1865..  . 203 

Sanitary  Statistics  of  South  Carolina .  203 

Small-pox  and  Vaccination  in  Georgia . . . .  206 

Deaths  from  All  Causes  and  from  Small-pox  in  the  White  Population  of  Savan¬ 
nah,  Georgia,  during  a  period  of  fifty  years,  1804-1853,  inclusive  . t .  207 

.  Total  Deaths  from  All  Causes  and  from  Small-pox  in  the  White  and  Colored  Pop¬ 
ulation  of  Savannah,  Georgia,  during  a  period  of  sixteen  years,  1854-1869.. .  207 

Deaths  from  Fever  and  Other  Causes  in  Savannah,  Georgia . .  209 

Small-pox  and  Vaccination  in  Augusta,  Georgia . . . .  211 

Deaths  from  All  Causes  and  from  Small-pox,  Whites  and  Blacks,  in  Augusta, 

Georgia,  during  forty-eight  years,  1818-1866 . .  211 

Introduction  of  Vaccination  into  the  Possessions  of  Spain  in  North  and  South 

America . 212 

The  Relations  of  Grease  in  the  Horses’  Heels  to  Cow-pox .  216 

Artificial  Production  of  Horse-pox  by  Inoculation ...  . .  220 

Artificial  Production  of  Horse-pox  by  Inoculation  by  Injection  of  Lymph .  220 

Character  and  Course  of  Horse-pox . . . .  222 

General  Description  of  Cow-pox . . .  222 

Observations  on  Cow-pox,  by  Robert  Ceely . .  223 

1  llusti'ation  of  the  Appearance  of  Cow-pox .  223 

General  Description  of  Cow-pox . . . .  223 

Comparative  View  of  the  Natural  Small-pox,  Inoculated  Small-pox  and  Cow-pox  227 

Small-pox  Contagion — Nature  of  the  Virus  of  Cow-pox  and  Small-pox .  .  228 

Small-pox  Communicated  to  Man  and  Animals  by  Eating  the  Small-pox  Matter, 

in  1792 .  229 

Microscopical  Character  of  Vaccine  Lymph  and  the  Contagious  Matter  from  the 

pustules  of  Small-pox  . 231 

Camparative  Phenomena  of  Inoculated  Small-pox  and  Cow-pox .  233 

Inoculated  Cow-pox  Vaccination .  234 

Phenomena  of  Variola  fSmall-pox) . .  .  235 


in. 


CONTENTS. 


Illustrations  of  Confluent  and  Distinct  Small-pox  and  of  Varioloid .  236-238 

Development  and  Structure  of  the  Small-pox  Pustules . . .  238 

Changes  of  the  Temperature  and  Urine  in  Small-pox  (Variola),  and  in  Modified 

Small-pox  (Varioloid) . 240 

Temperature  in  Small -pox . 241 

Temperature  in  Varioloid .  243 

Constituents  of  the  Urine  in  Varioloid  and  Variola . . .  246 

Spurious  Vaccination,  or  the  Abnormal  Phenomena  accompanying  and  following 

Vaccination . 251 

Causes  of  the  various  deviations  of  the  Vaccine  Disease  from  its  normal  course.  251 
In  the  Early  History  of  Vaccination,  protective  powers  against  certain  diseases 

were  erroneously  attributed  to  Cow-pox  inoculation .  252 

Spurious  Vaccination,  or  the  Abnormal  Fhenomena  accompanying  and  following 
Vaccination,  excited  the  attention  of  the  medical  profession  of  England  in 

the  earlier  period  in  the  history  of  vaccination .  254 

Attacks  upon  Vaccination  by  Dr.  Wm.  Eowley,  B.  Moseley,  R.  Squirrel  (John 

Gale  Jones! . 254 

Views  of  Dr.  Jenner  on  the  Causes  of  the  Abnormal  Phenomena  of  Vaccination.  255 
Researches  upon  Spurious  Vaccina  tion,  or  the  Abnormal  Phenomena  accompanying 
and  following  Vaccination  in  the  Confederate  army,  during  the  recent  Ameii- 

can  civil  war,  1861-1865,  by  Joseph  Jones.  M.  D .  259 

Section  I — Preliminary  Observations. — Accidents  attending  Vaccination  amongst 
the  citizens  and  soldiers  of  the  Confederate  States.  Necessity  for  the  inves¬ 
tigation.  Method,  extent  and  object  of  the  inquiry.  The  injurious  eifects 
of  vaccination  referred  to  six  causes.  Circular  letter  addressed  to  the  medi¬ 
cal  officers  of  the  late  Confederate  army .  . .  .  259-261 

Facts  Illustrating  the  value  of  Vaccination  and  the  fatality  of  Small-pox .  261 

Description  of  Small-pox  by  Sir  Mathew  Hale .  261 

Dr.  Jenner  pointed  out  some  Causes  of  the  Accidents  attending  Vaccination  and 

gave  rules  for  their  avoidance . .* . .  262 

Section  II — Modification,  alteration  and  degeneration  of  the  vaccine  vesicle,  de¬ 
pendent  upon  depressed  and  deranged  forces,  resulting  from  fatigue,  exposure 
and  poor  diet;  and  upon  unhealthy,  vitiated  and  scorbutic  conditions  of  the 

blood  of  the  patients  vaccinated  and  yielding  vaccine  matter .  264-287 

In  Scorbutic  patients  all  injuries  of  the  skin  tend  to  form  foul  ulcers  of  an  un¬ 
healthy  character . 268 

Effects  of  Scurvy  upon  the  character  and  progress  of  the  vaccine  vesicle.. .  273 

Investigations  upon  the  effects  of  Vaccination  amongst  the  Federal  Prisoners 

coufinedin  Camp  Sumpter,  Andersonville,  Georgia . 275 

Examination  of  the  charge  urged  by  the  United  States  Military  Commission, 
that  the  Confederate  Surgeons  deliberately  poisoned  or  destroyed  the  Fed¬ 
eral  prisoners  at  Andersonville,  with  poisonous  vaccine  matter. .  264-287 

Dr.  Hamilton  on  Spurious  Vaccination  in  the  United  States  Army .  274 

Dr.  L.  Guild  on  the  Medical  Records  of  the  Army  of  Northern  Virginia .  277 

Reports  on  Spurious  Vaccination  in  the  Confederate  Army,  by  S.  E.  Habersham.  278 
Report  of  Dr.  James  Bolton,  of  Richmond,  Virginia,  on  the  accidents  attending 

vaccination  in  the  Army  of  Northern  Virginia . .  281 

Letter  of  Gen.  R.  E.  Lee  with  reference  to  Federal  prisoners . .  289 

Hon.  Alexander  H.  Stephens  on  the  Condition  of  the  Federal  prisoners  at  Ander¬ 
sonville . .  285 

Letters  of  Gen.  J.  E.  Johnston,  G.  Beauregard  and  W.  Gilmore  Simms,  relative 

to  Federal  prisoners . 285 

Letters  of  Drs.  Middleton,  Michael,  Hunter  McGuire,  James  Bolton  and  Thomas 
F.  Wood,  relative  to  “  Researches  on  Spurious  Vaccination  in  the  Confed¬ 
erate  Army.” . 287 

Section  III. — The  Employment  of  Matter  of  Pustules  which  had  deviated  from 

the  regular  and  normal  course  of  development  in  the  vaccine  vesicle. .  288-309 

Such  Deviation  or  Imperfection  in  the  Vaccine  Disease  and  Pustule,  due  mainly 
to  previous  vaccination,  or  in  other  words,  the  employment  of  matter  from 
patients  who  had  been  previously  vaccinated,  or  who  were  affected  with 

some  skin  disease  at  the  time  of  the  insertion  of  the  vaccine  virus .  291 

Prof.  Paul  F.  Eve,  M.  D.,  on  Spurious  Vaccination .  289 

Dr.  R.  Hamilton,  of  Chattanooga,  Tenn.,  on  Spurious  Vaccination  amongst  the 

Confederate  forces  serviug  in  East  Tennessee .  .  .  __  290 

Investigations  of  Dr.  Edward  Jenner  on  the  Varieties  and"  Modifications  of  the 

Vaccine  Disease.. .  ..  . . _ .  291 

Answer  to  Dr.  Jenncr’s  Inquiries  by  the  Rector  of  Lackhamstead .  291 

Observations  of  Dr.  James  Davis,  of  Columbia,  South  Carolina,  on  the  Vaccine 

and  Varioloid  Disease.  ..... . . . . .  293 


CONTENTS.  vii. 


Examinations  of  tlie  Doctrine  of  John  Hunter  on  Diseased  Actions  as  being  in¬ 
compatible  with  each  other . .  295 

Relations  of  the  Vaccine  Disease  to  Measles  and  other  Diseases,  with  the  obser¬ 
vations  of  numerous  authors .  .  296-303 

Relations  of  Chicken-pox  to  Small-pox .  303 

History  and  Phenomena  of  Chicken-pox  (Varicella) .  303-309 

Differential  Diagnosis  between  Variola,  Varioloid  and  Varicella . .  308 

Section  IV. — Dried  Vaccine  Lymph  or  Scabs,  m  which  decomposition  has  been 
excited  by  carrying  the  matter  about  the  person  for  a  length  of  time,  and 

thus  subjecting  it  to  a  warm,  moist  atmosphere .  . _ . .  308-311 

Section  V. — The  Mingling  of  the  Vaccine  Virus  with  that  of  the  Small-pox  Mat¬ 
ter,  taken  from  those  who  were  vaccinated  while  they  were  laboring  under 

the  action  of  the  poison  of  small- pox .  311-317 

Observations  of  Drs.  Jenner,  Woodville,  Adams,  Willan,  George  Hennen,  Fowler 

and  Bosquet  upon  the  Relations  of  the  Vaccine  Disease  and  Small-pox _ 312-317 

Section  VI. — Dried  Vaccine  Lymph,  or  Scabs,  from  Patients  who  had  suffered 
with  Erysipelas  during  the  Progress  of  the  Vaccine  Disease,  or  whose  sys¬ 
tems  were  in  a  depressed  state  from  improper  diet,  bad  ventilation,  and  the 
exhalations  from  typhoid-fever,  erysipelas,  hospital  gangrene,  pviemia,  and 

offensive  suppurating  wounds . 317-330 

Dr.  Wm,  Gerdner,  of  Green  County,  Tennessee,  on  the  Relations  of  Erysipelas 

to  V accination . 318 

Cases  of  Erysipelas  Following  Revaccination,  reported  by  Dr.  Greene  to  the 

Boston  Society  for  Medical  Improvement .  319 

Cases  of  Erysipelas  Following  Vaccination,  reported  to  the  Boston  Society  for 
Medical  Improvement  by  Drs.  I.  B.  S.  Jackson,  Cabot,  Bigelow,  Hemans, 

Putnam  and  C banning . . .  ...  319 

Case  of  Constitutional  Irritation  Following  Vaccination,  reported  by  Dr.  Chas. 

E.  Buckingham,  of  Boston,  Massachusetts . . .  320 

Erysipelas  Following  Vaccination  in  the  French  Army .  321 

Observations  of  Various  Authors  on  Erysipelas  Following  Vaccination .  322 

Dr.  Paul  F.  Eve  did  not  admit  the  Possibility  of  the  Inoculation  of  Erysipelas 

by  Vaccination . . .  323 

Facts  Illustrating  the  Propagation  of  Erysipelas  by  Contagion .  324 

Testimony  of  Drs.  Wells,  Pitcairn,  Stevenson,  Gibson,  Lawrence,  George  Greg¬ 
ory,  Elliottson,  Arnott,  Thomas  Watson,  Rogers,  Campbell  de  Morgan  and 

others  as  to  the  Contagious  Nature  of  Erysipelas .  . , .  324-326 

Dr.  J.  C.  Nott  on  Erysipelas  in  the  Confederate  Army .  .  327 

Report  of  Dr.  J.  D.  Bell  on  the  Prevalence  of  Erysipelas  among  the  Confederate 
Wounded  in  the  Moore  Hospital,  Manassas  Junction,  Virginia,  in  the  month 

of  January,  1862  .  328 

Immunity  of  the  Army  of  General  Jackson  from  Erysipelas  :  report  of  Dr.  Hun¬ 
ter  McGnire,  Medical  Director  Army  of  Valley  of  Virginia .  .  329 

Section  VII — Fresh  and  Dried  Vaccine  Lymph  and  Scabs  from  Patients  suffering 
with  Secondary  or  Constitutional  Syphilis,  at  the  time  and  during  the  progress 

of  Vaccination  and  the  Vaccine  Disease .  331 

Vaccine  Syphilis  in  the  Confederate  Army .  332 

Testimony  of  Dr.  L.  D.  Gilmore  or  to  the  Syphilitic  Origin  of  a  portion  at  least 

of  the  cases  of  Spurious  Vaccination  in  the  Confederate  Army .  331 

Report  of  Dr.  James  Bolton,  on  the  Relations  of  Syphilis  to  Vaccination  in  the 

Confederate  Army . . . • .  334 

Testimony  of  Drs.  A.  II.  Powell,  J.  A.  Ethridge,  Hicks,  Haigill,  Rutherford, 

with  reference  to  the  causes  of  Spurious  Vaccination  in  the  Confederate  Army  337 

Dr.  Faul  F.  Eve  held  that  Syphilis  might  be  communicated  by  Vaccination .  338 

On  Vaccination  and  Variolous  Disease  by  Dr.  O.  Kratz . - —  338 

Dr.  Wm.  F.  Fuqua,  testified  as  to  the  Syphilitic  Origin  of  a  portion  at  least  ot  the 

cases  of  Spurious  Vaccination  in  the  Confederate  Army . .  339 

Outlie  Communicability  of  Syphilis  by  Vaccination,  by  Wm.  M.  Fuqua,  M.  D., 

Appomatax  County,  Va . . 341 

Abnormalities  of  Vaccination,  by  Frank  A.  Ramsey,  M.  D  . •_ .  341 

Dr.  Crawford,  of  Greenville,  Tenn.,  traced  the  impure  vaccine  virus  which  pro¬ 
duced  indurated  ulcers,  and  constitutional  syphilis,  to  a  single  individual, 
and  the  disease  thus  disseminated  by  inoculation  yielded  to  the  remedies 

best  adapted  to  the  treatment  of  syphilis . .  344 

Report  on  the  Communication  of  Syphilis  through  the  Medium  of  Vaccine  Virus 
amongst  the  inhabitants  of  Greenville  and  vicinity  in  South  Carolina,  in 

1866,  by  W.  F.  Percival,  M.  D.,  of  Aiken,  S.  C . . . . .  345 

Testimony  of  Dr.  E.  A.  Flewellen  as  to  the  Dissemination  of  Syphilis  by  Vac¬ 
cination  in  the  Confederate  Army . .  . . .  347 


CONTENTS. 


Small-pox  Epidemic  in  Mobile,  Alabama,  during  the  winter  of  1865-66,  by  Dr.  J. 

C.  Nott . 348 

Syphilitic  Vaccine  and  the  means  of  preventing  it .  . .  350 

Testimony  of  Dr.  Geo.  H.  Hubbard,  of  the  United  States  Army,  as  to  Yaccino- 

Syphilis . 351 

Opinion  of  Hebra,  as  to  the  question  whether  lymph  from  a  true  Jennerian  vesi¬ 
cle  has  ever  been  a  vehicle  of  syphilitic,  scrofulous  or  other  constitutional  in¬ 
fection  to  the  vaccinated  person  ? . 352 

Replies  of  Various  Surgeons  and  Physicians  as  Acton,  Adderson,  Balfour,  Bar- 
low,  Beatty,  Bright,  Brenton,  Brodie,  Burrows,  Busk,  Ceely,  Clark,  Cramp- 
ton,  Davis,  Erickson,  Farr,  Jenner,  Chesterfield,  Latham,  Locock,  Marson, 

Noble,  Tompkins,  Travers,  Watson,  West,  Williams,  Wilson,  Ackerly,  Ben¬ 
nett,  Fleming,  Hutchinson,  Lacock,  Lever,  Martin,  Morley,  Starten  and 
Whitehead,  to  the  question  propounded  in  1856,  by  Mr.  Simon,  “Whether 


Inoculability  of  Tubercle . . . .  355 

Experiments  of  M.  Villemin,  Lebert,  Burdon  Sanderson,  Koch  and  Formad  on 


Mortality  Occasioned  in  New  Orleans  and  the  Mississippi  Valley  by  Phthisis. . ..  356 

iEteology  of  Phthisis . 357 

Possibility  of  Transmitting  Scrofula  by  Vaccination — Views  of  Dr.  Edward 

Ballard . 361 

Inoculability  of  Cancer . . , .  36’2 

Contagious  Nature  of  Constitutional  Syphilis . 363 

Testimony  of  Gaspard  Torella  in  1498  as  to  the  Contagious  Nature  of  Constitu¬ 
tional  Syphilis . 363 

Facts  Published  by  William  Clowes  in  1637,  Illustrating  the  Contagious  Nature 

of  Constitutional  Syphilis .  364 

Testimony  of  Gideon  Harvey  in  his  “Venus  Unmasked,”  published  in  1665,  of 
Daniel  Turner  in  1717,  and  of  John  Hunter  in  1776,  as  to  the  Contagious  Na¬ 
ture  of  Constitutional  Syphilis. . 364-366 

Facts  Illustrating  this  Subject  Recorded  by  Drs.  Duncan,  William  Watson, 


Secondary  or  Constitutional  Syphilis . . .  370 

Communication  of  Syphilis  by  Vaccination;  Post-Vaccinal  Syphilis;  Vaccino- 

Syphilitic  Inoculation .  373 

Cases  of  Vaccino-Syphilis  Recorded  by  Dr.  Whitehead .  375 

Observations  of  M.  Viennois  on  Vaccino-Syphilis .  376 

Communication  of  Syphilis  to  Forty-six  Children  and  Twenty  Nurses,  at  Ra- 

valta,  Italy,  by  Vaccination .  377 

Account  of  the  Tragedy  of  Rivalta  by  Dr.  Paccliioiti,  of  Turin . .  377 

Genealogical  Scheme  of  the  Rivalta  Series  of  Vaccine-Syphilitic  Inoculations..  379 

The  Lupara  Series  of  Vaccino-Sypliilitic  Inoculations  . 380 

Genealogical  Scheme  of  Vaccino-Sypkilitic  Inoculations,  Lupara  Series .  381 

Bergatne  or  Terre  de  Busi  Series  of  Vaccino-Syphilitic  Inoculations .  382 

Genealogical  Scheme  of  Vaccino-Sypliilitic  Inoculations,  Bergame  Series .  393 

Vaccino-Syphilitic  Inoculations,  Auray  Series . .  383 

Genealogical  Scheme  of  Vaccino-Syphilitic  Inoculations,  Auray  Series .  383 

Cases  of  Vaccino-Syphilis  Recorded  by  Dr.  Jonathan  Hutchinson, .  386 

Modified  or  Lacto- Variolous  Inoculation . . .  398 

Variolation  of  the  Co  w . . .  401 

Animal  Vaccination . 403 

Precautions  for  the  Prevention  pf  Accidents  in  Vaccinatioq,  and  more  especially 

for  the  exclusion  of  the  Syphilitic  Virus . . .  407 


CONTAGIOUS 


AND 


MEASURES 

- FOR  THEIR - 

Prevention  and  Arrest, 

- BY - 

JOSEPH  JONES,  M.  D„ 

PRESIDENT  OF  THE 


OF  THE 


STATE  OIF1  LOTTISI  JlJSTJl. 


BATON  ROUGE : 

Leon  Jastremski,  State  Printer. 
1883. 


VACCINATION:  VARIOLA  VACCINE  (COW  POX):  VARIOLA, 
AND  VARIOLOID:  ACCIDENTS  ATTENDING  VAC¬ 
CINATION  :  SPURIOUS  VACCINATION. 


CIRCULAR  NO.  2— PREPARED  FOR  THE  GUIDANCE  OF  THE 
QUARANTINE  OFFICERS  AND  SANITARY  INSPECTORS 
OF  THE  BOARD  OF  HEALTH  OF  THE  STATE 

OF  LOUISIANA, 

- BY - 

JOSEPH  JONES,  M.  D.,  PRESIDENT  OF  THE  BOARD  OF  HEALTH  OF  THE 

STATE  OF  LOUISIANA. 


The  question  of  the  arrest  and  eradication  of  small-pox  has  been  re¬ 
garded  and  treated  by  the  Executive  Officer  of  the  Board  of  Health  of  the 
State  of  Louisiana  as  of  transcendent  importance  to  the  happiness  and 
welfare  of  the  people,  and  facts  were  recorded  in  Circular  No.  1,  issued 
on  the  sixteenth  of  August,  1883,  which  revealed  the  difficulties  of  deal¬ 
ing  with  this  question  in  the  delta  of  the  Mississippi,  and  more  especially 
in  the  city  of  New  Orleans;  and  the  measures  of  compulsory  vaccination, 
isolation  and  disinfection  which  had  been  in  past  times  urged  upon  the 
General  Assembly  and  the  municipal  authorities  were  again  strenuously 
advocated. 

No  city  upon  the  globe  is  more  exposed  to  the  introduction  and  spread 
of  small-pox  than  New  Orleans;  and  at  the  same  time  the  greatest 
difficulties  are  experienced  in  the  introduction  of  efficient  measures  for 
the  exclusion  and  arrest  of  this  pestilence. 

This  proposition  will  be  sustained  by  the  following  facts  : 

1.  New  ^Orleans  has  a  larger  colored  population  than  any  other  city  on 
the  North -American  Continent,  the  United  States  census  of  1880  giving 
total  population  216,090  ;  whites,  158,307;  colored,  57,617.  A  large  pro¬ 
portion  of  the  negro  population  not  only  neglect  vaccination,  but  are- 
opposed  to  this  protective  measure ;  New  Orleans,  therefore,  has  the  largest 
population  unprotected  and  liable  to  the  ravages  of  small-pox. 

2.  New  Orleans  has  the  largest  negro  population  immediately  tributary 
to  it  of  any  civilized  cit}r  in  the  world.  In  those  States  which  are  most 
nearly  related  to  New,  Orleans  by  geographical  position  and  commercial 
relations,  the  white  population  numbers  11,082,192,  out  of  a  total  popula¬ 
tion  of  the  United  States  of  50,155,783,  being  almost  one-fifth ;  the 
colored  population  numbers  3,158,051  out  of  a  colored  population  in  the 
United  States  of  6,580,793,  being  almost  one-half. 

Whilst  only  one-fifth  of  the  total  population  of  the  United  States  in¬ 
habits  the  States  of  Alabama,  Arkansas,  Kentucky,  Louisiana,  Missis¬ 
sippi,  Missouri,  Tennessee  and  Texas,  nearly  one-half  the  entire  negro 


4 


Joseph  Jones ,  M.  D.,  on  Contagious  Diseases. 


population  of  tliis  great  country  is  gathered  within  the  bounds  of  these 
States  which  are  most  directly  connected  with  New  Orleans,  by  geogra¬ 
phical  position  and  commercial  relations. 

3.  The  surrounding  States  tributary  to  New  Orleans  hare  neither  estab¬ 
lished  efficient  quarantines  against  small-p.ox, nor  have  their  health  authori¬ 
ties  reported  the  introduction  and  existence  of  this  disease,  to  the  Board 
of  Health  of  the  State  of  Louisiana. 

Small  pox  has  been  prevailing  in  the  Western  cities  and  in  the  villages 
and  plantations  along  the  Mississippi  river,  and  cases  have  during  1881, 
1882  and  1883,  been  continuously  introduced  into  New  Orleans  by  the  in¬ 
habitants  of  the  plantations  ;  the  settlements  of  which  form  almost  a  con¬ 
tinuous  village  for  nearly  one  thousand  miles  along  the  banks  of  this 
mighty  stream. 

it  is  not  surprising  that  ignorance  of  sanitary  laws,  and  neglect  of 
vaccination,  combined  with  unrestricted  intercourse,  should  have  found 
in  the  colored  race  along  the  banks  of  the  Mississippi  the  most  favorable 
condition  for  the  lodgment,  propagation,  spread  and  continuance  of  small¬ 
pox.  A  vast  floating  colored  population  continuously  pours  in  and  out  of 
New  Orleans  ;  large  numbers  of  colored  seamen  man  the  steamboats  which 
conduct  the  internal  commerce  of  this  great  valley,  and  they  have  during 
the  years  1881,  1882  and  1883,  been  the  medium  of  introducing  a  constant 
stream  of  small-pox  poison  into  New  Orleans. 

4.  As  long  as  small-pox  prevails  amongst  the  white  and'  colored  popula¬ 
tion  of  the  Mississippi  Valley  and  of  the  States  tributary  to  this  com¬ 
mercial  centre,  just  so  long  will  this  disease  continue  to  find  successive 
lodgment  in  New  Orleans.  The  extent  to  which  the  population  of  New 
Orleans  will  suffer  from  each  introduction  of  the  small  pox  poison  will 
depend  upon  the  number  of  citizens,  unprotected  by  vaccination  or  by 
preceding  attacks  of  small-pox. 

5.  The  opposition  to  vaccination  is  not  confined  to  the  uneducated  and 
comparatively  helpless  colored  race,  who  by  the  results  of  the  American 
Civil  War  of  1861-18G5,  have  been  precipitated  into  a  state  of  freedom,  de¬ 
manding  for  its  intelligent  and  successful  enjoyment  some  knowledge  of 
sanitary  as  well  as  of  political  science;  bitter  opponents  to  vaccination 
have  been  found  amongst  the  white  race,  and  in  the  ranks  of  the  medical 
profession,  and  their  efforts  have  up  to  the  present  moment  defeated  in  the 
General  Assembly  of  Louisiana,  and  in  the  Municipal  Government  of  New 
Orleans,  all  efforts  to  eradicate  small  pox,  by  the  institution  ol  laws  ren¬ 
dering  vaccination  compulsory. 

On  the  twenty-ninth  of  May,  1883,  the  following  ordinance  relative  to 
vaccination  was  presented  to  the  Common  Council  of  New  Orleans,  read  in 
full  and  referred  to  the  Committee  on  Health  ;  on  the  twenty-sixth  of  June 
1883,  read  and  failed  to  pass  ;  August  14,  read  and  ordered  to  be  laid  over, 
August  28,  read  and  ordered  to  be  laid  over  one  week ;  September  4,  1883, 
lost : 

AN  ORDINANCE  BY  THE  CITY  COUNCIL. 

“Section  1.  That  all  children  of  the  city  of  New  Orleans  shall  be  vac¬ 
cinated  before  same  attain  the  age  of  two  years,  said  vaccination  shall  be 
successful  or  repeated  such  a  number  of  times  as  to  make  it  evident  that 
successful  vaccination  is  impossible  ;  and  such  children  and  all  other  per¬ 
sons  as  is  hereinafter  provided,  shall  be  re-vaccinated  as  often  as  the 
Board  of  Health  or  other  legally  authorized  officers  shall  require,  pro¬ 
vided  that  no  person  or  child  of  full  age  shall  be  required  to  be  success¬ 
fully  vaccinated  more  than  once  during  any  pormd  of  five  years. 


Compulsory  Vaccination. 


5 


“Sec.  2.  Be  it  further  ordained,  that  any  resident  of  the  city  of  New  Or¬ 
leans  over  the  age  of  fifteen  years,  who  has  not  been  successfully 
vaccinated  after  a  lapse  of  five  years,  since  successful  vaccination,  and 
who  after  twenty -four  hours’  notice  to  that  effect  given  by  officers  legally 
authorized  thereto,  shall  fail  or  refuse  to  be  vaccinated,  may  be  arrested 
and  taken  before  the  Recorder’s  Court,  having  jurisdiction,  and  oh  convic¬ 
tion,  fined  in  a  sum  not  exceeding  twenty-five  dollars  or  imprisonment  not 
exceeding  thirty  days,  the  fines  so  imposed  and  collected  to  be  turned  over 
to  the  Board  of  Health,  and  any  parent  or  guardian  or  person  having  con¬ 
trol  of  a  child  under  fifteen  years  of  age,  and  who  on  notice  as  herein 
stated,  shall  fail  to  vaccinate  shall  be  subject  to  the  penalties  herein 
provided. 

“Sec.  3.  Beit  further  ordained ,  that  the  Board  of  Health  shall  be  and  is 
hereby  authorized  to  provide  the  means  and  facilities  for  vaccination 
which  shall  be  free  to  all  persons;  and  shall  or  may  authorize  the  physi¬ 
cian  in  attendance  in  any  case  on  application  to  give  a  certificate  of  the 
time  when  successful  vaccination  shall  have  been  performed  on  any 
person. 

“Such  certificate  shall  be  evidence  and  proof  of  the  fact  therein  stated, 
and  a  re-vaccination  shall  be  necessary  within  a  period  of  five  years  from 
the  date  of  the  vaccination  stated  therein.” 

This  subject  was  again  urged  upon  the  attention  of  the  Board  of  Health 
of  the  State  of  Louisiana,  as  will  be  shown  by  the  following  extracts  from 
the  proceedings  of  that  date  : 

EXTRACT  FROM  THE  PROCEEDINGS  OF  THE  MEETING  OF  THE 
BOARD  OF  HEALTH,  STATE  OF  LOUISIANA,  SEP¬ 
TEMBER  6,  1883. 


The  President,  Dr.  Joseph  Jones,  presented  the  following  report  : 

HEALTH  OF  NEW  ORLEANS. 

Mortality  of  New  Orleans ,  during  the  Months  of  July  and  August,  1883. 


WEEK  ENDING 

Deaths. 

Total 

Deaths . 

Death  Hate. 

Total 

Death 

Kate. 

IV. 

c. 

W. 

C. 

Julv  I .  . 

75 

41 

116 

23.83 

35.56 

26.98 

July  14 . 

79 

38 

117 

25.11 

32.96 

27.21 

July  21 . 

82 

58 

140 

26,06 

50.31 

32.56 

July  28 . 

95 

45 

140 

30.19' 

39.03 

32.56 

August  4 . 

83 

55 

138 

26  38 

47.71 

32.09 

August  11 . 

77 

48 

125 

24,47 

41.63 

29.07 

August  18 . . . 

74 

46 

120 

23.52 

39.90 

27.91 

August  25 . 

73 

43 

116 

23.20 

37.30 

26.96 

September  1 . . . 

63 

48 

111 

20.02 

41.64 

28 . 82 

Total  deaths  for  the  four  weeksending  July  28,  513;  total  deaths  for 
the  four  weeks  ending  September  25,  499  ;  total  deaths  for  the  eight  weeks 
July  1  to  September  25,  1012;  total  deaths  for  the  nine  weeks  July  1,  Sep¬ 
tember  1,  1124  ;  average  number  of  deaths  for  the  months  of  July  and 
August,  562. 

An  actual  examination  of  the  record  shows  that  the  total  number  of 
deaths  in  Julv  were  572;  and  that  the  actual  mortality  of  August  was 

531. 


€) 


Joseph  Jones ,  M.  D.,  on  Arrest  of  Small-Pox. 


Tlie  mortality  in  New  Orleans  during  the  first  eight  months  of  1883  has 
been  as  follows  : 

Total  Deaths.  Total  Deaths. 

January . 607  May . 666 

February . 607  June . 654 

March . 734  July . tTZ 

April . 713  August . . 531 

Total  deaths  sis  months  3981. 

Total  deaths  first  eight  months  of  1883,  5084. 

We  observe  therefore  that  the  lowest  monthly  mortality  has  occurred 
during  the  months  of  July  and  August,  the  hottest  and  dryest  months  of 
1883,  and  the  lowest  mortality  has  been  attained  during  the  month  of 
August,  when  the  deaths  numbered  only  531. 


MORTALITY  FROM  SMALL  POX  DURING  THE  FIRST  EIGHT- 

MONTHS  OF  1883. 


The  progress  of  the  small  pox  of  1883,  will  be  illustrated  by  the  follow 
ing  table : 

DEATHS  FROM  SMALL  POX  IX  THE  CITY  OF  XEW  ORLEANS,  DURING  THE  FIRST  EIGHT 


MONTHS. 


J anuary  . 
February 
March. . . . 

April . 

May . 

Jnne . 

July . 

August. . . 


MONTHS  OF  1883. 


Deaths  from 

Small-pox. 

Total  Deaths  from 
Small-pox. 

White. 

Colored. 

White  &  Colored. 

24 

52 

76 

48 

83 

131 

72 

147 

219 

102 

159 

261 

80 

95 

175 

53 

96 

149 

44 

40 

84 

31 

36 

67 

Total  deaths  from  small-pox  during  the  first  six  months  of  1883,  whites 
379;  colored  634.  Total  whites  and  colored  1013. 

Average  number  of  deaths  from  small-pox,  during  the  first  six  months 
of  1883,  168.8. 

Total  deaths  from  small  pox  during  the  months  of  July  and  August  1883, 
whites,  75  ;  colored  76.  Total  151.  Average  number  of  deaths  during  the 
months  of  July  and  August  from  small-pox  75.15. 

Total  deaths  from  small-pox  during  the  first  eight  months  of  1883, 
1164. 

Average  number  of  deaths  per  month  during  1883,  first  eight  months, 
145.5. 

It  is  evident  therefore  that  the  small-pox  has  decreased  one-half  during 
the  months  of  July  and  August. 

But  this  foul  disease  is  still  in  onr  city,  and  demands  the  most  earnest 
and  careful  consideration  at  the  hands  of  the  Board  ot  Health  and  the  City 
Council. 

A  sufficient  corps  of  physicians,  not  less  than  one  to  each  ten  thousand 
inhabitants,  should  be  at  once  appointed  and  properly  paid  to  execute  a 
careful  house-to-house  inspection  and  vaccination. 

Vaccination  should  be  personally  urged  upon  each  inhabitant,  by  the 
experienced  and  trusted  local  practitioners  of  each  division. 

Twenty  physicians  at  850  per  month,  $1000. 

Service  of  twenty  physicians  at  $50  per  month,  for  five  months,  October, 
November,  December,  January,  February,  $5000. 


Joseph  Jones ,  M.  I).,  on  Arrest  of  Small- Pox. 


7 


Vaccine  matter  85  per  month  to  each  physician,  twenty  physicians,  $100 
per  month.  Total  cost  of  vaccine  matter  $500. 

The  most  experienced  and  popular  physicians  should  be  appointed  in  the 
districts  in  which  they  reside,  and  they  should  be  required  to  make  a  care¬ 
ful  census  of  the  district,  giving  the  following  data  : 

Inhabitants :  Whites,  colored.  Total  whites  and  colored. 

Humber  of  inhabitants  who  have  had  small  pox  :  Whites,  colored. 

Total  number  of  inhabitants  who  have  been  vaccinated  previous  to 
census :  Whites,  colored. 

Total  number  of  inhabitants  unvaccinated  :  Whites,  colored. 

Humber  vaccinated  (primary)  by  inspector:  Whites,  males,  females. 
Total-Colored,  males,  females.  Total — . 

Re- vaccinations  by  inspector  :  Whites,  males,  females.  Total — Colored, 
males,  females.  Total—. 

Humber  of  those  who  refuse  vaccination:  Whites,  males,  females. 
Total — Colored,  males,  females.  Total — . 

A  careful  list  of  all  persons,  with  their  exact  residences  and  places  of 
business,  who  refuse  vaccination,  should  be  kept. 

This  list  should  be  classified  after  the  completion  of  the  canvass  in  each 
district,  and  the  homes,  residence  and  occupations  of  all  those  refusing 
vaccination,  should  be  published  for  the  information  and  protection  of  the 
public. 

In  this  manner  employes,  heads  of  factories  and  heads  of  families  would 
be  warned  as  to  the  existence  of  dangerous  and  unprotected  elements  in 
their  midst. 

Some  laws  should  be  enacted  against  all  vessels  or  railroads  bringing 
cases  of  small-pox  into  Hew  Orleans. 

The  entire  police  of  this  city  should  be  instructed  to  arrest  all  persons 
found  with  small-pox  on  them  wandering  in  the  streets,  and  immediately 
send  them  to  the  small- pox  hospital. 

If  the  proper  funds  were  placed  at  the  disposal  of  the  Board  of  Health 
to  execute  the  foregoing  plan,  much  would  be  accomplished  to  eradicate 
this  disease;  the  act  of  1877  empowers  the  Board  of  Health  to  execute  the 
necessary  rules  and  regulations  with  reference  to  vaccination,  provided  that 
it  be  not  made  compulsory. 

The  preceding  measures,  proposed  by  the  President,  were  discussed  and 
warmly  advocated  by  Ool.  I.  H.  Marks  and  Col.  A.  W.  Bosworth,  and 
Dr.  Felix  Formento  introduced  the  following  resolution,  which  was  unani¬ 
mously  adopted ; 

Resolved ,  That  a  medical  officer  be  appointed  by  this  Board  of  Health 
for  each  ward  of  the  city,  whose  duties  shall  be  to  visit  personally  every 
house  in  his  ward,  and  to  urge  the  necessity  of  immediate  vaccination,  and 
vaccination  of  any  person  liable  to  contract  the  disease  living  in  it,  and 
making  distinct  statements  of  the  results  of  his  investigation  in  accord¬ 
ance  with  the  plan  suggested  by  the  President  of  the  Board  of  Health. 

Resolved ,  That  the  city  authorities  be  requested  to  appropriate  sufficient 
funds  in  order  to  defray  the  necessary  expense,  such  as  salary  of  physicians, 
supply  of  vaccine  matter,  etc. 

In  accordance  with  the  preceding  action  of  the  Board  of  Health  the 
following  communication  was  addressed  to  His  Honor  Wm.  J.  Behan, 
Mayor  of  the  city  of  Hew  Orleans,  on  the  tenth  of  September  1883. 


8 


Free  Vaccination  ;  House-to- House  Inspection. 


Office  Board  of  Health,  State  of  Louisiana,  > 
New  Orleans,  September  10,  1S83.  ] 

Hon.  W.  J.  Belian,  Mayor  of  New  Orleans,  City  Hall : 

Sir — I  have  tlie  lionor  to  enclose  for  the  consideration  of  your 
Honor  and  the  honorable  the  Common  Council  of  New  Orleans,  extract 
from  the  minutes  of  the  Board  of  Health,  and  resolutions  unanimously 
adopted  relative  to  the  suppression  of  small  pox. 

During  the  past  eight  months  of  1883,  one  thousand  one  hundred  and- 
sixty-four  citizens  of  New  Orleans  have  perished  from  small  pox.  The 
monthly  deaths  caused  by  small-pox  are  as  follows  :  January  76,  February 
131,  March  219,  April  261,  May  175,  June  149,  July  84,  August  67.  The 
total  deaths  from  all  causes  including  small -pox  in  New  Orleans,  during 
the  same  period,  was  5084.  Small-pox  has  therefore  caused  nearly  one- 
fourth  of  all  the  deaths  occurring  in  New  Orleans  in  1883. 

From  the  preceding  statistics,  it  is  evident  that  small-pox,  has  decreased 
to  a  marked  extent  during  the  months  of  July  and  August,  and  that  the 
present  is  auspicious  for  the  institution  of  measures  for  its  arrest. 

The  plan  which  I  proposed,  and  which  was  endorsed  by  the  Board  of 
Health,  was  briefly  to  appoint  one  physician  for  each  ten  thousand  inhabi¬ 
tants,  who  should  visit  every  place  of  business  or  factory  and  each  habi¬ 
tation,  and  urge  vaccination  upon  each  citizen.  A  careful  census  to  be 
made,  embracing  number  of  inhabitants,  number  protected  by  preceding 
attacks  of  small  pox,  by  vaccination  and  re-vaccination,  and  therefore  the 
number  refusing  to  be  vaccinated  and  liable  to  and  unprotected  from  the 
disease. 

This  work  should  be  continued  during  the  months  of  October,  November, 
December,  January,  February  and  March,  or  until  the  thorough  canvass  of 
the  city  had  been  made,  and  the  offer  of  free  vaccination  had  been  made  to, 
and  urged  upon,  every  citizen. 

The  cost  of  twenty  physicians  at  $50  each  per  month  would  be  $1000 
per  month  or  $6000  per  six  months.  The  extended  and  vital  operations  of 
quarantine  as  well  as  the  important  duties  connected  with  the  registration 
of  births,  deaths  and  marriages,  together  with  the  various  sanitary  opera¬ 
tions  of  importance,  as  inspection  disinfection,  and  the  promulgation  by 
weekly  and  annual  publications  of  the  mortuary  and  sanitary  operations, 
absorb  the  available  resources  of  the  Board  of  Health. 

It  is  therefore  essential  that  the  Municipal  Government  should  make  the 
necessary  appropriation  for  the  protection  of  its  citizens  from  this  destruc¬ 
tive  pestilence. 

The  matter  of  finance  could  be  conducted  in  the  same  manner  to  that  now 
employed  in  city  sanitation  by  the  Board  of  Health  :  each  physician’s  name 
to  be  entered  upon  the  pay  roll,  and  said  roll  tobe  submitted  to  the  Honorable 
Common  Council  and  paid  by  special  ordinance.  In  this  manner  the  work 
could  be  stopped,  and  the  expense  closed  as  soon  as  the  city  had  beeu  in¬ 
spected,  and  the  vaccination  urged  upon  every  citizen  and  inhabitant. 

If  I  am  correctly  informed,  your  honorable  body  has  already  expended 
during  1883,  up  to  August  31,  $14,094  for  the  support  of  Small-Pox  Hospi¬ 
tals  ;  how  much  more  will  be  required  to  meet  other  expenses  cannot  be 
estimated. 

It  would  be  difficult  to  estimate  the  cost,  the  loss  of  business,  etc.  If  the 
value  of  each  human  life  be  rated  at  the  moderate  sum  of  one  thousand 
dollars,  then  during  the  eight  months  of  1883,  New  Orleans  has  lost  by 
small-pox  (a  preventable  pestilence)  $1,164,000. 

(Signed)  JOSEPH  JONES,  M.  D., 

President  Board  of  Health,  State  of'  Louisiana. 


Joseph  Jones ,  M.  D.,  on  History  of  Vaccination. 


9 


The  opposition  to  vaccination  was  referable  to  several  causes  such  as : 

1.  Ignorance,  superstition  and  prejudice. 

2.  Stupid  and  malicious  opposition  to  all  measures  emanating  from  the 
Board  of  Health  for  the  protection  of  the  health  and  lives  of  the  people. 

3.  Disbelief  in  the  protective  powers  of  vaccination. 

4.  A  popular  superstition  that  vaccination  during  the  prevalence  of 
small-pox  tended  to  develope  the  disease  in  the  person  vaccinated. 

5.  The  belief- held  by  many  people  and  by  some  physicians  that  the 
vacciue  virus  has  degenerated  since  its  introduction  by  Edward  Jenner  in 
1798. 

G.  The  frequent  failure  of  the  bovine  virus  furnished  by  the  various  vac¬ 
cine  farms  of  the  United  States. 

7.  The  dread  of  contracting  syphilis,  phthisis,  erysipelas,  scrofula  and 
leprosy,  through  the  medium  of  the  vaccine  virus. 

8.  The  dread  of  contracting  various  diseases  of  animal  origin,  through 
the  medium  of  the  bovine  virus. 

These  statements,  but  more  especially  the  3d,  4th,  5th,  Oth,  7tli  and  8th, 
propositions,  demand  careful  investigation. 

The  difficulty  of  procuring  reliable  vaccine  matter  during  the  recent 
civil  war  as  well  as  the  remarkable  abnormal  phenomena  presented  by  the 
vccaine  disease  in  some  cases  amongst  the  Confederate  (Southern)  Army, 
led  the  author  to  institute  an  extended  investigation  of  all  subjects  bear¬ 
ing  upon  vaccination;  and  it  is  believed  to  be  of  paramount  importance 
that  the  results  of  these  labors  should  now  be  fully  recorded. 

Conceiving  that  the  entire  investigation  could  not  be  perfected  without 
a  full  and  careful  persual  of  the  original  works  of  Edward  Jenner ;  and, 
as  after  the  most  diligent  search  for  many  years  in  the  book  stores  and 
libraries  of  the  United  States,  the  author  was  unable  to  procure  or  examine 
these  immortal  productions,  he  conducted  a  similar  search  amongst  the 
book  stores  of  Paris,  London,  Edinburgh,  Oxford,  Liverpool,  and  Canarvan,' 
Wales,  during  a  visit  10  Europe  in  1870. 


After  diligent  personal  search  amongst  the  book  stores  of  London,  I 
succeeded  in  obtaining  three  copies  of  the  works  of  Edward  Jenner,  namely  : 
“Inquiry  into  the  causes  and  effects  of  the  variolae  vaccinaa,  a  disease  dis¬ 
covered  in  some  of  the  Western  counties  of  England  particularly  Glouces¬ 
tershire,  and  known  by  the  name  of  The  Cow-Pox.  By  Edward  Jenner,  M. 
D.  F.  It.  S.  etc.,”  published  in  London,  June  1798.  “Further  observations  on 
the  variolae  vaccimc,”  published  in  London  in  1800,  in  connection  with  his 
“Inquiry  into  the  cause  and  effects  of  the  variolae  vaccina?.”  “A  continua¬ 
tion  of  facts  and  observations  relative  to  the  variolae  vaccimc  or  cow-pox, 
by  Edward  Jenner,  M.  D.  F.  It.  S.  and  L.  S.  etc.,  London  1800.” 

Jenner  published  a  third  edition  of  his  works  in  1801 ;  which  was  essen¬ 
tially  the  same  as  the  second  edition  published  in  1800,  and  contained  three 
distinct  papers,  namely  : 


“An  inquiry  into  the  causes  and  effects  of  the  variolae  vacciuae.” 
“Further  observation  on  the  variolae  vaccina?. ” 

“A  continuation  of  facts  and  observations  relative  to  the  variolae  vac- 


cinaeJ’ 


We  have,  aftercareful  consideration  of  the  grave  situation,  arrived  at  the 
firm  conviction,  that  the  public  welfare  demands,  that  at  this  time,  when 
small-pox  prevails  in  the  Delta  of  the  Mississippi,  and  in  the  commercial 
metropolis  of  the  Valley,  and  when,  at  the  same  time,  mistrust  as  to 
the  efficacy  of  vaccination,  is  manifested  by  the  people  and  by  a  portion  of 


10 


Works  of  Edward  Jenner. 


the  medical  profession,  that  the  original  works  of  Edward  Jenner  should 
he  reproduced,  in  Louisiana, 

We  have  selected  the  third  edition  of  the  works  of  Edward  Jenner, 
published  in  London  in  1801,  because  we  find,  upon  careful  comparison  of 
the  three  editions,  published  respectively  in  1798, 1800  and  1801 ;  that  the 
latter  appears  to  have  received  the  most  careful  revision  by  the  author. 

The  second  edition,  published  in  1800,  has  written  upon  the  fly-leaves 
1ST.  Prythorch,  Surgeon  Carmarthen  1800,  December  1G;  liobert  Marsh  Wil¬ 
liams,  seventeenth  March,  1841.  The  corrections  have  been  written  at  the 
proper  places,  in  the  separate  memoirs. 

The  name  of  Bichard  Pearson  is  written  across  the  title  page  of  the  third 
edition. 

I  have  selected  the  plates  from  the  first  edition  published  in  1798,  be¬ 
cause  the  impressions  are  better  defined,  and  colored  with  more  care,  than 
those  of  the  second  and  third  editions,  the  identical  plates  appearing  to 
have  been  used  in  the  printing  of  the  three  editions.  Jenner  gives  four 
plates,  all  illustrative  of,  and  included  in,  his  orginal  “inquiry  iuto  the 
causes  and  effects  of  the  variola}  vaccina}.”  The  first  plate  facing  page 
thirty-two,  showing  the  appearance  of  the  hand  of  a  dairy  maid,  (Sarah 
Nelmes,  Case  xvi,)  infected  with  the  cow-pox  from  her  masters  cows  in  May 
179G,  is  given  in  full:  the  second,  third  and  fourth  plates  (Case  xviii  p.  3G ; 
Case  xx.  p.  38 ;  Case  xxi.  p  .  40),  have  been  placed  upon  a  single  plate,  as 
it  appeared  to  be  a  useless  expense  to  reproduce  the  mere  outlines  of  the 
arms,  these  portions  showing  nothing  of  note  as  far  as  the  process  and 
effects  of  vaccination  were  concerned. 

The  following  is  the  title  and  preface  to  the  first  edition  of  the  inquiry 
of  Dr.  Edward  Jenner. 

“An  Inquiry  into  the  causes  and  effects  of  the  variolse  vaccinse,  a  disease 
discovered  in  some  of  the  western  counties  of  England,  particularly  Glou¬ 
cestershire,  and  known  by  the  name  of  The  Cow-Pox.  By  Edward  Jenner, 
M.  D.  F.  B.  S.,  &c. 

Quid  Nohis  Certius  Ipsis  Sensibus  Esse  Potest ,  Quo  Vera  ac  Falsa  Notemus. 
Lurcretius. 

London,  printed  for  the  author  by  Sampson  Low,  No.  7  Berwick  street 
Soho. 

And  sold  by  Law,  Ave-Maria  Lane ;  and  Murray  and  Highley,  Fleet 
street,  1798.” 


TO  C.  H.  PABKY,  M.  D.,  AT  BATH. 

My  Dear  Friend — In  the  p resent  age  of  scientific  investigation,  it  is  re¬ 
markable  that  a  disease  of  so  peculiar  a  nature  as  the  cow-pox,  which  has 
appeared  in  this  and  some  of  the  neighboring  counties  for  such  a  series  of 
years,  should  so  long  have  escaped  particular  attention.  Finding  the  pre¬ 
vailing  notions  on  the  subject,  both  among  men  of  our  profession  and 
others,  extremely  vague  and  indeterminate,  and  conceiving  that  facts 
might  appear  at  once  both  curious  and  useful,  I  have  instituted  as  strict  an 
inquiry  into  the  causes  and  effects  of  this  singular  malady  as  local  circum¬ 
stances  would  admit. 

The  following  pages  are  the  result,  which,  from  motives  of  the  most  affec¬ 
tionate  regard,  are  dedicated  to  you,  by 

Your  sincere  friend,  '  EDWAI1D  JENNEB. 

Berkley,  Gloucestershire.  June  21,  1798. 


AN  INQUIRY 


— —  INTO - 

THE  CAUSES  AAlsTIC  EFFECTS 

- OF  THE  — — 


A  DISEASE  DISCOVERED  IN  SOME  OF  THE  WESTERN  COUNTIES  OF  ENGLAND 
PARTICULARLY  GLOUCESTERSHIRE,  AND  KNOWN  BY  THE  NAME  OF 

the  cow  zporxi- 


— BY — 

EDWARD  JENNER,  M.  D.  F.  R.  S.  &C 


- QUID  NOBIS  CERTIUS  IPSIS 

SENSIBUS  ESSE  POTEST,  QUO  YERA  AC  FALSA  NOTEMUS 

LUCRETIUS. 


THE  THIRD  EDITION. 


.  LONDON: 

PRINTED  FOR  THE  AUTHOR, 

By  D.  N.  Shury,  No.  7,  Berwick  street,  Solio; 

And  Sold  by  Hurst,  Paternoster  Row;  Murray  &  Higliley,  Fleet  Street  ;  Carpentri 

Old  Bond  Street;  and  Callow,  Crown  Court. 

1801. 


* 


0 


( 


TO  THE  KIXG. 


Sir — When  I  first  addressed  the  public  on  a  physiological  subject,  which 
I  conceived  to  be  of  the  utmost  importance  to  the  future  welfare  of  the 
human  race,  I  could  not  presume,  in  that  early  stage  of  the  investigation, 
to  lay  the  result  of  my  inquiries  at  your  Majesty’s  feet. 

Subsequent  inquiries  instituted  not  only  by  myself  but  by  men  of  the 
first  rank  in  the  medical  profession  have  now  confirmed  the  truth  of  the 
theory  which  I  first,  made  known  to  the  world. 

Highly  honored  by  the  permission  to  dedicate  the  result  of  my  inquiries 
to  your  Majesty,  I  am  emboldened  to  solicit  your  gracious  patronage  of  a 
discovery  which  reason  fully  authorizes  me  to  suppose  will  prove  peculiarly 
conducive  to  the  preservation  of  the  lives  of  mankind. 

To  a  Monarch  no  less  justly  than  emphatically  styled  the  Father  of  his 
people,  this  treatise  is  inscribed  with  perfect  propriety ;  for,  conspicuous 
as  your  Majesty’s  patronage  lias  been  of  arts,  of  sciences  and  of  commerce, 
yet  the  most  distinguished  feature  of  your  character  is  your  paternal  care 
for  the  dearer  interests  of  humanity. 

I  am,  sir,  with  the  most  profound  respect,  your  Majesty’s  most  devoted 
subject  and  servant, 

EDWARD  0ENKER. 

Berkeley,  Gloucestershire,  December  20,  1799. 


AN  INQUIRY,  &C.,  &0. 


The  deviation  of  man  from  the  state  in  which  he  was  originally  placed 
by  nature  seems  to  have  proved  to  him  a  prolific  source  of  diseases.  From 
the  love  of  splendor,  from  the  indulgences  of  luxury,  and  from  his  fondness 
for  amusement,  he  has  familiarized  himself  with  a  great  number  of  animals 
which  may  not  originally  have  been  intended  for  his  associates. 

The  wolf,  disarmed  of  ferocity,  is  now  pillowed  in  the  lady’s  lap  *  The 
cat  the  little  tiger  of  our  island,  whose  natural  home  is  the  forest,  is 
equally  domesticated  and  caressed.  The  cow,  the  hog,  the  sheep,  and  the 
horse,  are  all,  for  a  variety  of  purposes,  brought  under  his  care  and 
dominion. 

There  is  a  disease  to  which  the  horse,  from  his  state  of  domestication,  is 
frequently  subject.  The  farriers  have  termed  it  the  Greafe.  It  is  an  inflam¬ 
mation  and  swelling  in  the  heel,  accompanied  at  its  commencement  with 
small  cracks  or  fissures,  from  which  issues  a  limpid  fluid,  possessing  prop¬ 
erties  of  a  very  peculiar  kind.  This  fluid  seems  capable  of  generating  a 
disease  in  the  human  body,  (after  it  has  undergone  the  modification  I  shall 
presently  speak  of),  which  bears  so  strong  a  resemblance  to  small  pox  that 
I  think  it  highly  probable  that  it  may  be  the  source  of  that  disease. 

In  this  dairy  county  a  great  number  of  cows  are  kept,  and  the  office  of 
milking  is  performed  indiscriminately  by  men  and  maid  servants.  One  of 
the  former  having  been  appointed  to  apply  dressings  to  the  heels  of  a 
horse  affected  with  the  malady  I  have  mentioned,  and  not  paying  due 
attention  to  cleanliness,  incautiously  bears  his  part  in  milking  the  cows, 
with  some  particles  of  the  infectious  matter  adhering  to  his  fingers.  When 
this  is  the  case  it  frequently  happens  that  a  disease  is  communicated  to 
the  cows  and  from  the  cows  to  the  dairy  maids,  which  spreads  through 
the  farm  until  most  of  the  cattle  and  domestics  feel  its  unpleasant  conse¬ 
quences.  This  disease  has  obtained  the  name  of  cow  pox.  It  appears  on 
the  nipples  of  the  cows  in  the  form  of  irregular  pustules.  At  their  first 
appearance  they  are  commonly  of  a  palish  blue,  or  rather  of  a  color  some¬ 
what  approaching  to  livid,  and  are  surrounded  by  an  inflammation.  These 
pustules,  unless  a  timely  remedy  be  applied,  frequently  degenerate  into 
phagedenic  ulcers,  which  prove  extremely  troublesome.!  The  animals 
become  indisposed,  and  the  secretion  of  the  milk»is  much  lessened.  In¬ 
flamed  spots  now  begin  to  appear  on  different  parts  of  the  hands  of  the 
domestics  employed  in  milking,  and  sometimes  on  the  wrists,  which  run 
on  to  suppuration,  first  assuming  the  appearance  of  the  small  vesications 
produced  by  a  burn.  Most  commonly  they  appear  about  the  joints  of 
the  turners  and  at  their  extremities,  but  whatever  parts  are  affected,  if  the 
situation  will  admit,  these  superficial  suppurations  put  on  a  circular  form, 
with  their  edges  more  elevated  than  their  centre,  and  of  a  color  distantly 
approaching  to  blue.  Absorption  takes  place  and  tumors  appear  in  each 

*The  late  Mr.  John  Hunter  proved  by  experiments  that  the  dog  is  the  wolf  in  a  degenerated  state. 

tThev  who  attend  sick  cattle  in  this  country  find  a  speedy  remedy  for  stopping  the  progress  of  this 
complaint  in  those  applications  whicli  act  chemically  upon  the  morbid  matter,  snch  as  the  solutions  of  the 
vitriolum  zinci,  the  vitriolum  cupri,  etc. 


Variolce  Vaccince :  Edward  Jenner. 


15 


axilla.  The  system  becomes  affected,  the  pulse  is  quickened;  shiveriugs, 
succeeded  by  heat,  general  lassitude  and  pains  about  the  loins  and  limbs, 
with  vomiting,  come  on.  The  head  is  painful,  and  the  patient  is  now  and 
then  affected  with  delirium.*  These  symptoms,  varying  in  their  degrees  of 
violence,  generally  continue  from  one  day  to  three  or  four,  leaving  ulcer¬ 
ated  sores  about  the  hands,  which,  from  the  sensibility  of  the  parts,  are 
very  troublesome  and  commonly  heal  slowly,  frequently  becoming  phage¬ 
denic,  like  those  from  whence  they  sprung.  During  the  progress  of  the 
disease,  the  lips,  nostrils,  eyelids,  and  other  parts  of  the  body,  are  some¬ 
times  affected  with  sores ;  but  these  evidently  arise  from  their  being  heed¬ 
lessly  rubbed  or  scratched  with  the  patient’s  infected  fingers.  No  erup¬ 
tions  on  the  skin  have  followed  the  decline  of  the  feverish  symptoms  in 
any  instance  that  lias  come  under  my  inspection,  one  only  excepted,  and  in- 
this  case  a  very  few  appeared  on  the  arms.  They  were  very  minute,  of  a 
vivid  red  color,  and  soon  died  away,  without  advancing  to  maturation,  so 
that  I  cannot  determine  whether  they  had  any  connection  with  the  preced¬ 
ing  symptoms. 

Thus  the  disease  makes  its  progress  from  the  horse,  as  I  conceive,  to  the 
nipple  of  the  cow,  and  from  the  cow  to  the  human  subject. 

Morbid  matter  of  various  kinds,  when  absorbed  into  the  system,  may 
produce  effects  in  some  degree  similar ;  but  what  renders  the  cow  pox  virus 
so  extremely  singular  is  that  the  person  who  has  been  thus  affected  is  for 
ever  after  secure  from  the  infection  of  the  small  pox ;  neither  exposure  to 
the  variolous  effluvia  nor  the  insertion  of  the  patter  into  the  skin  produc¬ 
ing  this  distemper. 

In  support  of  so  extraordinary  a  fact,  I  shall  lay  before  my  reader  a 
great  number  of  instances.  But  first  it  is  necessary  to  observe  that  pus¬ 
tulous  sores  frequently  appear  spontaneously  on  the  nipples  of  the  cows, 
and  instances  have  occurred,  though  very  rarely,  of  the  hands  of  the  ser¬ 
vants  employed  in  milking  being  affected  with  sores  in  consequence,  and 
even  of  their  feeling  an  indisposition  from  absorption.  These  pustules  are 
of  a  much  milder  nature  than  those  which  arise  from  that  contagion  which 
constitutes  the  true  cow  pox.  They  are  always  free  from  the  bluish  or 
livid  tint  so  conspicuous  in  the  pustules  in  that  disease.  No  erysipelas 
attends  them,  nor  do  they  show  any  phagedenic  disposition,  as  in  the  other 
case,  but  quickly  terminate  in  a  scab,  without  creating  any  apparent  dis¬ 
order  iii  the  cow.  This  complaint  appears  at  various  seasons  of  the  year, 
but  most  commonly  in  the  spring,  when  the  cows  are  first  taken  from  their 
winter  food  and  fed  with  grass-.  It  is  very  apt  to  appear  also  when  they 
are  suckling  their  young.  But  this  disease  is  not  to  be  considered  as 
similar  in  any  respect  to  that  of  which  I  am  treating,  as  it  is  incapable  of 
producing  any  specific  effects  on  the  human  constitution.  However,  it  is 
of  the  greatest  consequence  to  point  it  out-  here,  lest  the  want  of  discrimi¬ 
nation  should  occasion  an  idea  of  security  from  the  infection  of  the  small 
pox,  which  might  prove  delusive. 


CASE  I. 

Joseph  Merrett.  now  an  under  gardener  to  the  Earl  of  Berkeley,  lived  as  a  servant 
with  a  farmer  near  this  place, in  the  year  1770,  and  occasionally  assisted  in  milking  his 
master’s  cows.  Several  horses  belonging  to  the  farm  began  to  have  sore  heels,  which 
Merrett  frequently  attended.  The  cows  soon  became  affected  with  the  cow-pox,  and 
soon  after  several  sores  appeared  on  his  hands.  Swellings  and  stiffness  in  each  axilla 


*It  will  appear  in  the  sequel  that  these  symptoms  arise  principally  from  the  irritation  of  the  sores,  and 
not  from  the  primary  action  of  the  vaccine  virus  upon  the  constitution. 


16 


Variolas  Vacoince :  Edward  Jenner. 


followed,  and  lie  was  so  much  indisposed  for  several  days  as  to  be  incapable  of  pursuing 
his  ordinary  employment.  Previously  to  the  appearance  of  the  distemper  among  the 
cows  there  was  no  fresh  cow  brought  into  the  farm,  nor  any  servant  employed  who  was 
affected  with  the  cow-pox. 

In  April,  1795,  a  general  inoculation  taking  place  here,  Merrett  was  inoculated  with 
his  family,  so  that  a  period  of  twenty-live  years  had  elapsed  from  his  having  the  cow- 
pox  to  this  time.  However,  though  the  variolous  matter  was  repeatedly  inserted  into 
his  arm,  I  found  it  impracticable  to  infect  him  with  it,  an  effioresence  only,  taking  on  an 
erysipelatous  look  about  the  centre,  appearing  on  the  skin  near  the  punctured  parts. 
During  the  whole  time  that  his  family  had  the  small-pox,  one  of  whom  had  it  very  full, 
he  remained  in  the  house  with  them,  but  received  no  injury  from  exposure  to  the  con¬ 
tagion  . 

it  is  necessary  to  observe  that  the  utmost  care  was  taken  to  ascertain,  with  the  most 
scrupulous  precision,  that  no  one  whose  case  is  here  adduced  had  gone  through  the  small¬ 
pox  previous  to  these  attempts  to  produce  that  disease. 

Had  these  experiments  been  conducted  in  a  large  city,  or  in  a  populous  neighbor¬ 
hood,  some  doubts  might  have  been  entertained  ;  but  here,  where  population  is  thin,. and 
where  such  an  event  as  a  person’s  having  had  the  small-pox  is  always  faithfully 
recorded,  no  risk  of  inaccuracy  in  this  particular  can  arise. 


,  CASE  II. 

Sarah  Portlock,  of  this  place,  was  infected  with  the  cow-pox,  when  a  servant  at  a 
farmer’s  in  the  neighborhood,  twenty-seven  years  ago.* 

In  the  year  1792,  conceiving  herself,  from  this  circumstance,  secure  from  the  infection 
of  the  small-pox,  she  nursed  one  of  her  own  children,  who  had  accidentally  caught  the 
disease,  but  no  indisposition  ensued.  During  the  time  she  remained  in  the  infected 
room,  variolous  matter  was  inserted  into  her  arms,  but  without  any  further  effect  than 
in  the  preceding  case. 


CASE  HE 

John  Phillips,  a  tradesman  of  this  town,  had  the  cow-pox  at  so  early  a  period  as  nine 
years  of  age.  At  the  age  of  sixty-two  I  inoculated  him,  and  was  very  careful  in  select¬ 
ing  matter  in  its  most  active  state.  It  was  taken  from  the  arm  of  a  boy  just  before  the 
commencement  of  the  eruptive  fever,  and  instantly  inserted.  It  very  speedily  pro¬ 
duced  a  sting-like  feel  in  the  part.  An  efflorescence  appeared,  which  on  the  fourth  day 
■was  rather  extensive,  and  some  degree  of  pain  and  stiffness  was  felt  about  the  shoulder  ; 
but  on  the  fifth  day  -these  symptoms  began  to  disappear,  and  in  a  day  or  two  after  went 
entirely  off,  without  producing  any  effect  on  the  system. 


CASE  IV. 

Mary  Barge,  of  Woodford,  in  this  parish,  was  inoculated  with  variolous- matter  in 
the  year  1791.  An  efflorescence  of  a  palish  red  color  soon  appeared  about  the  parts 
where  the  matter  was  inserted,  and  spread  itself  rather  extensively,  but  died  away  in  a 
few  days  without  producing  any  variolous  symptoms.!  She  has  since  been  repeatedly 
employed  as  a  nurse  to  small-pox  patients  without  experiencing  any  ill  consequences. 
This  woman  had  the  cow-pox  when  she  lived  in  the  service  of  a  farmer  in  this  parish 
thirty-one  years  before. 


CASE  V. 

Mrs.  H - ,  a  respectable  gentlewoman  ot  this  town,  had  the  cow-pox  when  very 

young.  She  received  the  infection  in  a  manner  that  is  not  common.  It  was  given  by 

*1  have  purposely  selected  several  cases  in  which  the  disease  had  appeared  at  a  very  distant  period  pre¬ 
vious  to  the.  experiments  made  with  variolous  matter,  to  show  that  the  change  produced  in  the  constitu¬ 
tion  is  not  affected  by  time. 

tit  is  remarkable  that  variolous  matter,  when  the  system  is  disposed  to  reject  it,  should  excite  inflamma¬ 
tion  on  the  part  to  which  it  is  applied  more  speedily  than  when  it  produces  the  small-pox.  Indeed,  it 
becomes  almost  a  criterion  by  which  we  can  determine  whether  the  infection  will  he  received  or  not.  It 
seems  as  if  a  change,  which  endures  through  life,  had  been  produced  in  the  action,  or  disposition  to  action, 
in  the  vessels  of  the  skin  ;  and  it  is  remarkable,  too,  that  whether  tins  change  has  been  effected  by  the 
small-pox  or  the  cow-pox  that  the  disposition  to  sudden  cuticular  inflammation  is  the  same  on  the  application 
of  variolons  matter. 


Variolce  Vaccina ? :  Edward  Jenner. 


17 


means  of  lier  handling  some  of  the  same  utensils*  which  were  in  use  among  the  servants 
of  the  family,  who  had  the  diabase  from  milking  infected  cows.  Her  hands  had  many  of 
the  cow-pox  sores  upoii  them,  and  they  were  communicated  to  her  nose,  which  became 

inflamed  and  very  much  swollen.  Soon  after  this  event  Mrs.  H - was  exposed  to  the 

contagiou  of  the  small-pox,  where  it  was  scarcely  possible  for  her  to  have  escaped,  had 
she  been  susceptible  of  it,  as  she  regularly  attended  a  relative  who  had  the  disease  in 
so  violent  a  degree  that  it  proved  fatal  to  him. 

In  the  year  1778  small-pox  prevailed  very  much  at  Berkeley,  and  Mrs.  IT - ,  not 

feeling  perfectly  satisfied  respecting  her  safety  (no  indisposition  having  followed  her 
exposure  to  the  small-pox),  I  inoculated  her  with  active  variolous  matter.  The  same 
appearance  followed  as  in  the  preceding  cases — an  efflorescence  on  the  arm,  without  any 
effect  on  the  constitution. 


CASE  YI. 

It  is  a  fact  so  well  known  among  our  dairy  farmers,  that  those  who  have  had  the 
small  pox  either  escape  the  cow-pox  or  are  disposed  to  have  it  slightly,  that  as  soon  as 
the  complaint  shows  itself  among  the  cattle,  assistants  are  procured,  if  possible,  who 
are  thus  rendered  less  susceptible  of  it,  otherwise  the  business  of  the  farm  could  scarcely 
go  forward. 

In  the  month  of  May,  1796,  the  cow-pox  broke  out  at  Mr.  Baker’s,  a  farmer  who  lives 
near  this  place.  The  disease  was  communicated  by  means  of  a  cow,  which  was  pur¬ 
chased  in  an  infected  state  at  a  neighboring  fair,  and  not  one  of  the  farmer’s  cows,  con¬ 
sisting  of  thirty,  which  were  at  that  time  milked,  escaped  the  contagion.  The  family 
consisted  of  a  man  servant,  two  dairy  maids  and  a  servant  boy,  who,  with  the  farmer 
himself,  were  twice  a  day  employed  in  milking  the  cattle.  The  whole  of  this  family, 
except  Sarah  Wynne,  one  of  the  dairymaids,  had  gone  through  the  small-pox.  The  con¬ 
sequence  was  that  the  farmer  and  the  servant  boy  escaped  the  infection  of  the  cow-pox 
entirely,  and  the  servant  man  and  one  of  the  maid  servants  had  each  of  them  nothing 
more  than  a  sore  on  one  of  their  fingers,  which  produced  no  disorder  in  the  system.  But 
the  other  dairy  maid,  Sarah  Wynne,  who  never  had  the  small-pox,  did  not  escape  in  so 
easy  a  manner.  She  caught  the  complaint  from  the  cows,  and  was  affected  with  the 
symptoms  described  in  the  fifth  page  in  so  violent  a  degree  that  she  was  confined  to  her 
bed,  and  rendered  incapable  for  several  days  of  pursuing  her  ordinary  vocations  in  the 
farm. 

March  28th,  1797,  I  inoculated  this  girl,  and  carefully  rubbed  the  variolous  matter 
into  slight  incisions  made  upon  the  left,  arm.  A  little  inflammation  appeared  in  the 
usual  manner  around  the  parts  where  the  matter  was  inserted,  but  so  early  as  the  fifth 
day  it  vanished  entirely  without  producing  any  effect  on  the  system. 


CASE  VII. 

Although  the  preceding  history  pretty  clearly  evinces  that  the  constitution  is  far 
less  susceptible  of  the  contagion  of  the  cow-pox  after  it  has  felt  that  of  the  small-pox, 
and  although  in  general,  as  i  have  observed,  they  who  have  had  the  small-pox,  and  are 
employed  in  milking  cows  which  are  infected  with  the  cow-pox,  either  escape  the  dis¬ 
order,  or  have  sores  outlie  hands  without  feeling  any  general  indisposition,  yet  the 
animal  economy  is  subject  to  some  variation  in  this  respect,  which  the  following  rela¬ 
tion  will  point  out : 

In  the  summer  of  the  year  1796  the  cow-pox  appeared  at  the  farm  of  Mr.  Andrews,  a 
considerable  dairy  adjoining  to  the  town  of  Berkeley.  It  was  communicated,  as  in  the 
•  preceding  instance,  by  an  infected  cow  purchased  at  a  fair  in  the  neighborhood.  The 
family  consisted  of  the  farmer,  his  wife,  turn  sons,  a  man  and  a  maid  servant,  all  of 
whom,  except  the  farmer,  who  was  fearful  of  the  consequences,  bore  a  part  m  milking 
the  cows.  The  whole  of  them,  exclusive  of  the  man  servant,  had  regularly  gone  through 
the  small-pox;  but  in  this  case  no  one  who  milked  the  cows  escaped  the  contagion.  All 
ol  them* had  sores  upon  their  hands,  and  some  degree  of  general  indisposition, .preceded 
by  palps  and  tumors  in  the  axilla ;  but  there  was  no  comparison  in  the  severity  ol  the 
disease  as  it  was  felt  by  the  servant  man,  who  had  escaped  the  small-pox,  and  by  those 
of  the  family  who  had  not;  for,  while  he  was. confined  to  his  bed,  they  were  able,  with¬ 
out  much  inconvenience,  to  follow  their  ordinary  business. 


*  When  the  cow-pox  lias  prevailed  in  the  dairy,  it  has  often  been  coinmuuicated  to  those  who  h  avo  not 
milked  the  cows  by  the  handle  of  the  xnilk  pail. 


Variola;.  Vaccina; :  Edward  Jenner. 


18 


February  13,  1797,  I  availed  myself  of  an  opportunity  of  inoculating  William  Rodway, 
the  servant  man  above  alluded  to.  Variolous  matter  was  inserted  into  both  bis  arms  : 
in  the  right  by  means  of  superficial  incisions,  and  into  the  left  by  slight  punctures  into 
the  cutis.  Both  were  perceptibly  inflamed  on  the  third  day!  After  this  the  inflamma¬ 
tion  about  the  punctures  soon  died  away,  but  a  small  appearance  of  erysipelas  was 
manifest  about  the  edges  of  the  incisions  till  the  eighth  day,  when  a  little  uneasiness 
was  felt  for  the  space  of  half  an  hour  in  the  right  axilla.  The  inflammation  then  hastily 
disappeared,  without  producing  the  most  distant  mark  of  affection  of  the  system. 


case  virr. 

Elizabeth  Wynne,  aged  fifty-seven,  lived  as  a  servant  with  a  neighboring  farmer 
thirty-eight  years  ago.  She  was  then  a  dairy  maid,  and  the  cow-pox  broke  out  among 
the  cows.  She  caught  the  disease  with  the  rest  of  the  family,  but,  compared  with  them, 
had  it  in  a  very  slight  degree,  one  very  small  sore  only  breaking  out  on  the  little  finger 
of  her  left  hand,  and  scarcely  any  perceptible  indisposition  following  it. 

As  the  malady  had  shown  itself  iu  so  slight  a  manner,  and  as  it  had  taken  place  at  so 
distant  a  period  of  her  life,  I  was  happy  with  the  opportunity  of  trying  the  effects  of 
variolous  matter  upon  her  condition,  and  on  the  twenty-eighth  of  March,  1797,  I  inocu¬ 
lated 'her  by  making  two  superficial  incisions  on  the  left  arm,  on  which  the  matter  was 
cautiously  rubbed.  A  little  efflorescence  soon  appeared,  and  a  tingling  sensation  was 
felt  about  the  parts,  where  the  matter  was  inserted,  until  the  third  cffiy,  when  both 
began  to  fade,  and  so  early  as  the  fifth  day  it  was  evident  that  no  indisposition  would 
follow. 


CASE  IX. 

Although  the  cow-pox  shields  the  constitution  from  the  small-pox,  and  the  small-pox- 
proves  a  protection  against  its  own  future  poison,  yet  it  appears  that  the  human  body  is 
again  and  again  susceptible  of  the  infectious  matter  of  the  cow-pox,  as  the  following 
history  will  demonstrate: 

William  Smith,  of  Pvrtou,  in  this  parish,  contracted  this  disease  when  he  lived  with 
a  neighboring  farmer  in  the  year  1780.  One  of  the  horses  belonging  to  the  farm  had 
sore  heels,  and  it  fell  to  his  lot  to  attend  him.  By  these  means  the  infection  was  carried 
to  the  cows,  and  from  the  cows  it  was  communicated  to  Smith.  On  one  of  his  hands 
were  several  ulcerated  sores,  and  he  was  affected  with  such  symptoms  as  have  been  be¬ 
fore  described. 

In  the  year  1791  the  cow-pox  broke  out  at  another  farm  where  he  then  lived  as  a  ser¬ 
vant,  and  he  became  affected  with  it  a  second  time ;  and  in  the  year  1794  he  was  so  un¬ 
fortunate  as  to  catch  it  again.  The  disease  was  equally  as  severe  the  second  and  third 
time  as  it  was  on  the  first.* 

In  the  spring  of  the  year  1795  he  was  twice  inoculated,  but  no  affection  of  the  system 
could  be  produced  from  the  variolous  matter;  and  he  has  since  associated  with  those 
who  had  the  small-pox  in  its  most  contagious  state  without  feeling  any  effect  from  it. 


CASE  X. 

Simon  Nichols  lived  as  a  servant  with  Mr.  Bromedge,  a  gentleman  who  resides  on  his 
own  farm,  in  this  parish,  in  the  year  1782.  He  was  employed  in  applying  dressings 
to  the  sore  heels  of  one  of  his  master’s  horses,  and  at  the  same  time  assisted  in  milking 
the  cows.  The  cows  became  affected  in  consequence,  but  the  disease  did  not  show  itself 
on  their  nipples  till  several  weeks  after  he  had  begun  to  dress  the  horse.  He  quitted 
Mr.  Bromedge’s  service,  and  went  Jto  another  farm,  without  any  sores  upon  him  ;  but 
here  his  hands  soon  began  to  be  affected  in  the  common  way,  and  be  was  much'in disposed, 
with  the  usual  symptoms-  Concealing  the  nature  of  the  malady  from  Mr.  Cole,  his 
new  master,  and  being  there  also  employed  in  milking,  the  cow-pox  was  communicated 
to  the  cows. 

Some  years  afterwards  Nichols  was  employed  in  a  farm  where  the  small-pox  broke 
out,  when  I  inoculated  him  with  several  other  patients,  with  whom  he  continued 
during  the  whole  time  of  their  confinement.  His  arm  inflamed,  but  neither  the 
inflammation  nor  his  associating  with  the  inoculated  family  produced  the  least  effect 
upon  his  constitution. 

*This  is  not  the  case  in  general — a  second,  attack  is  commonly  very  slight,  and  so,  I  aminformed.it  is 
among  the  cows.  The  reader  will  find  further  observations  bn  this  subject  in  the  sequel.  These  re¬ 
peated  indispositions  must  have  arisen  from  the  local  irritation,  and  not  from  the  specific  action  of  the 
vaccine  virus- 


Variola ?  Vaccina' :  E (heard  Jenner. 


19 


CASE  XI. 

William  Stinchcomb  was  a  fellow  servant  with  Nichols  at  Mr.  Brom edge’s  farm,  at  the 
time  the  cattle  had  the  cow-pox,  and  he  was  unfortunately  infected  by  them.  Bis  left 
hand  was  very  severely  affected  with  several  corroding  ulcers,  and  a  tumor  of  consider¬ 
able  size  appeared  in  the  axilla  of  that  side.  Bis  right  hand  had  only  one  small  sore 
upon  it,  and  no  tumor  discovered  itself  in  the  corresponding  axilla. 

In  tlie  year  1792  Stinchcomb  was  inoculated  with  variolous  matter,  but  no  conse¬ 
quences  ensued  beyond  a  little  inflammation  in  the  arm  for  a  fe \v  days.  A  large  party 
were  inoculated*  at  the  same  time,  some  of  whom  had  the  disease  in  a  more  violent 
degree  than  is  commonly  seen  from  inoculation.  He  purposely  associated  with  them, 
but.  could  not  receive  the  small-pox. 

During  the  sickening  of  some  of  his  companions  their  symptoms  so  strongly  recalled 
to  his  mind  his  ow  n  late  when  sickening  w  ith  the  cow-pox,  that  he  very  pertinently 
remarked  their  striking  similarity. 


CASE  XII. 

The  paupers  of  the  village  of  Tort  worth,  in  this  county,  were  inoculated  by  Mr. 
Henry  Jenner,  surgeon,  of  Berkeley,  in  the  year  1795.  Among  them  eight  patients  pre¬ 
sented  themselves  who  had  at  different  times  in  their  lives  had  the  cow-pox.  One  of 
them,  Bester  Walkley,  1  attended  w  ith  that  disease  when  he  lived  in  the  service  of  a 
farmer  in  the  same  village  in  the  year  1782;  but  neither  this  woman,  nor  any  other  of 
tue  patients  w  ho  had  gone  through  the  cow-pox,  received  the  variolous  infection  either 
from  the  arm  or  from  mixing  in  the  society  of  the  other  patients  who  w  ere  inoculated 
at  the  same  time.  This  state  of  security  proved  a  fortunate  circumstance,  as  many  of 
the  poor  women  were  at  the  same  time  in  a  state  of  pregnancy. 


CASE  XIII. 

One  instance  has  occurred  to  me  of  the  system  being  affected  from  the  matter  issuing 
from  the  heels  of  horses,  and  of  its  remaining  afterwards  unsusceptible  of  the  variolous 
contagion  ;  another,  where  the  small-pox  appeared  obscurely  ;  and  a  third  in  which 
its  complete  existence  was  positively  ascertained. 

First,  Thomas  Pearce  is  the  son  of  a  smith  and  farrier  near  to  this  place.  Be  never 
had  the  cow-pox,  but  in  consequence  of  dressing  horses  with  sore  heels  at  his  father’s, 
w7hen  a  lad,  he  had  sores  on  his  fingers,  which  suppurated,  and  which  occasioned  a 
pretty  severe  indisposition.  Six  years  aftcrw’ards  I  inserted  variolous  matter  into  his 
arm  repeatedly,  without  being  able  to  produce  anything  more  than  a  slight  inflamma¬ 
tion,  which  appeared  very  soon  after  the  matter  was  applied,  and  afterwards  I  expostd 
him  to  the  contagion  of  the  small-pox  with  as  little  effect* 


CASE  XIY. 

Secondly,  Mr.  James  Cole,  a  farmer  in  this  parish,  had  a  disease  from  the  same  sourco 
as  related  in  the  preceding  case,  and  some  years  after  was  inoculated  wdth  variolous 
matter,  Be  had  a  little  pain  in  the  axilla,  and  felt  a  slight  indisposition  for  three  or 
four  hours.  A  few  eruptions  showed  themselves  on  the  forehead,  but  they  very  soon 
disappeared  w  ithout  advancing  to  maturation. 


CASE  XY. 

Although  m  the  two  foimer  instances  the  system  seemed  to  bo  secured,  or  nearly  so, 
from  variolous  infection  by  the  absorption  of  matter  from  sores  produced  by  the 
diseased  heels  of  horses,  yet  the  following  case  renders  it  probable  that  this  cannot  be 
entirely  relied  upon  until  a  disease  has  been  generated  by  the  morbid  matter  from  the 
horse  on  the  nipple  of  the  cow,  and  passed  through  that  medium  to  the  human  subject. t 
Mr.  Abraham  Kiddiford,  a  farmer  at  Stone,  in  this  parish,  in  consequence  of  dressing 
a  mare  that  had  sore  heels,  was  affected  with  very  painful  sores  in  both  his  hands, 
tumors  in  each  axilla,  and  severe  and  general  indisposition.  A  surgeon  in  the  neighbor- 

*It  is  a  remarkable  fact,  and  well  known  to  many,  that  we  are  frequently  foiled  in  our  endeavors!  to  com¬ 
municate  the  small-pox  by  inoculation  to  blacksmiths,  who  in  tlie  country  are  farriers.  They  often,  as  in 
1  he  above  instance,  either  resist  the  contagion  entirely,  or  have  the  disease  anomalously .  Shall  we  not  be 
able  now  to  account  for  this  on  a  rational  principle? 

tThe  succeeding  part  will  give  further  explanations  of  this  subject. 


20 


Variola  Vaccina? :  Edward  Jenncr. 


hood  attended  him,  who,  knowing  the  similarity  between  the  appearance  of  the  sores 
upon  his  hands  and  those  produced  by  the  cow-pox,  and  being  acquainted  also  with  the 
effects  of  that  disease  on  the  human  constitution,  assured  him  that  lie  never  need  to 
fear  the  infection  of  the  small-pox  :  but  this  assertion  proved  fallacious,  for,  on  being 
exposed  to  the  infection  upwards  of  twenty  years  afterwards,  he  caught  the  disease, 
which  took  its  regular  course  in  a  Very  mild  way.  There  certainly  was  a  difference  per¬ 
ceptible,  although  it  is  not  easy  to  describe  it,  in  the  general  appearance  of  the  pustules 
from  that  which  we  commonly  see.  Other  practitioners,  who  visited  the  patient  at  my 
request,  agreed  with  me  in  this  point,  though  there  was  no  room  left  for  suspicion  as  to 
the  reality  of  the  disease,  as  I  inoculated  some  of  his  family  from  the  pustules,  who  had 
the  small-pox,  with  its  usual  appearances,  in  consequence. 


CASE  XYI. 

Sarah  Nelmes,  a  dairy  maid  at  a  farmer’s  near  this  place,  was  infected  with  the  cow- 
pox  from  her  master’s  cows,  in  May,  1796.  She  received  the  infection  on  a  part  of  the 
hand  which  had  been  previously,  in  a  slight  degree,  injured  by  a  scratch  from  a  thorn. 
A  large,  pustulous  sore,  and  the  usual  symptoms  accompanying  the  disease,  were  pro¬ 
duced  in  consequence.  The  pustule  was  so  expressive  of  the  true  character  of  the  cow- 
pox,  as  it  commonly  appears  upon  the  hand,  that  I  have  given  a  representation  of  it  in 
the  annexed  plate.  The  two  small  pustules  on  the  wrists  arose  also  from  the  applica¬ 
tion  of  the  virus  to  some  minute  abrasions  of  the  cuticle,  but  the  livid  tint,  if  they  ever 
had  any,  was  not  conspicuous  at  the  time  I  saw  the  patient.  The  pustule  on  the  fore¬ 
finger  shows  the  disease  in  an  earlier  stage.  It  did  not  actually  appear  on  the  hand  of 
this  young  woman,  but  was  taken  from  that  of  another,  and  is  annexed  for  the  purpose 
of  representing  the  malady  after  it  has  newly  appeared. 


CASE  XVII. 

The  more  accurately  to  observe  the  progress  of  the  infection,  I  selected  a  healthy  boy, 
about  eight  years  old,  for  the  purpose  of  inoculation  for  the  cow-pox.  The  matter  was 
taken  from  a  sore  on  the  hand  of  a  dairy  maid*,  who  was  infected  by  her  master’s  cows, 
and  it  was  inserted  on  the  fourteenth  of  May,  1796,  into  the  arm  of  the  boy,  by  means  of 
two  superficial  incisions,  barely  penetrating  the  cutis,  each  about  half  an  inch  long. 

On  the  seventh  day  he  complained  of  uneasiness  in  the  axilla,  and  on  the  ninth  he 
became  a  little  chilly,  lost  his  appetite,  and  had  a  slight  headache.  During  the  whole 
of  this  day  he  was  perceptibly  indisposed,  and  spent  the  night  with  some  degree  of 
restlessness,  but  on  the  following  day  he  was  perfectly  'well. 

The  appearance  of  the  incisions  in  their  progress  to  a  state  of  maturation  were  much 
the  same  as  when  produced  in  a  similar  manner  by  variolous  matter. t  The  only  differ¬ 
ence  which  1  perceived  was  in  the  state  of  the  limpid  fluid  arising  from  the  action  of 
virus,  which  assumed  rather  a  darker  hue,  and  in  that  of  the  afflorescence  spreading 
round  the  incisions,  which  had  more  of  an  erysipelatous  look  than  we  commonly  per¬ 
ceive  when  variolous  matter  has  been  made  use  of  in  the  same  manner;  but  the  whole 
died  away  (leaving  on  the  inoculated  parts  scabs  and  subsequent  scars)  without  giving 
me  or  my  patient  the  least  trouble. 

In  order  to  ascertain  whether  the  boy,  after  feeling  so  slight  an  affection  of  the  sys¬ 
tem  from  the  cow-pox  virus,  was  secure  from  the  contagion  of  the  small-pox,  he  was  in¬ 
oculated  the  first  of  July  following  with  variolous  matter,  immediately  taken  from  a 
pustule.  Several  slight  punctures  and  incisions  were  made  on  both  his  arms,  and  the 
matter  was  carefully  inserted,  but  no  disease  followed.  The  same  appearances  were  ob¬ 
servable  on  the  arms  as  we  commonly  see  when  a  patient  has  had  variolous  matter 
applied,  after  having  either  the  cow-pox  or  the  small  pox.  Several  months  afterwards 
.  he  was  again  inoculated  with  variolous  matter,  but  no  sensible  effect  was  produced  on  * 
the  constitution. 

Here  my  researches  were  interrupted  till  the  spring  of  the  year  1798,.  when,  from  the 
wetness  of  the  early  part  of  the  season,  many  of  the  farmer’s  horses  in  this  neighborhood 
were  affected  with  sore  heels,  in  consequence  of  which  the  cow-pox  broke  out  among 
several  of  our  dairies,  which  afforded  me  an  opportunity  of  making  further  observations 
upon  this  curious  disease. 


*Fromthe  sore  on  the  hand  of  Sarah  Holmes. — See  the  preceding  case  and  the  plate. 

tThis  appearance  was,  in  a  great  measure,  new  to  me,  and  I  ever  shall  recollect  the  pleasant  sensations 
it  excited  ;  as,  from  its  similarity  to  the  pustule  produced  by  variolous  inoculation,  it  iucontestibly  pointed 
out  the  close  connection  between  the  two  diseases,  and  almost  anticipated  the  result  of  my  future  experi¬ 
ments. 


■  \*\v0 

;  v'.' ;  .^Oo^&^»«5t§§ 


tfSBB 


•  v  .r>  ’ 


VARIOLA  VACCINE. 


PLATE  17. 


TXf  NEW  ORLEANS  UT«.C?  10  UNION  ST. 


Variola ?  Yaccince  :  Edward  Jenner. 


09 


year  old.  By  the  application  of  mercurial  ointment  to  the  inflamed  parts  (a  treatment 
recommended  under  similar  circumstances  in  the  inoculated  small-pox)  the  complaint 
subsided  without  giving  much  trouble. 

Hannah  Excell,  a  healthy  girl  of  seven  years  old,  and  one  of  the  patients  above 
mentioned,  received  the  infection  from  the  insertion  of  the  virus  under  the  cuticle  of 
the  arm  in  three  distinct  points*  The  pustules  which  arose  in  consequence  so  much  re¬ 
sembled,  on  the  ninth  day,  those  appearing  from  the  insertion  of  variolous  matter,  that 
an  experienced  inoculator  would  scarcely  have  discovered  a  shade  of  difference  at  that 
period.  Experience  now  tells  me  that  almost  the  only  variation  which  follows  consists 
in  the  pustulous  fluids  remaining  limpid  nearly  to  the  time  of  its  total  disappearance, 
and  not,  as  in  the  direct  small-pox,  becoming  purulent.  (See  plate  No.  4.) 


CASE  XXII. 

From  the  arm  of  this  girl  matter  was  taken  and  inserted  April  12  into  the  arms  of  John 

Marklove,  one  year  and  a  half  old. 

Robert  F.  Jenner,  eleven  months  old  ; 

Mary  Pead,  five  years  old  ;  and 

Mary  James,  six  years  old. 

Among  these,  Robert  F.  Jenner  did  not  receive  the  infection.  rIhe  am  s  of  the  other 
three  inflamed  properly,  and  began  to  affect  the  system  in  the  usual  manner  ;  but, 
being  under  some  apprehension  from  the  preceding  cases  iliat  a  troublesome  erysipelas 
might  arise,  I  determined  on  making  an  experiment,  with  the  view  of  cutting  off  its 
source.  Accordingly,  on  the  eighth  day  after  the  path  nts  had  felt  an  indisposition  that 
was  just  perceptible,  of  about  twelve  hours,  I  applied  in  two  of  these  cases  out  of  the 
three,  on  the  vesicle  formed  by  the  virus,  a  little  mild  caustic,  composed  of  equal  parts 
of  quicklime  and  soap,  and  suffered  it  to  remain  on  1  lie  }  art  six  Louis, t  ll  seen  eel  to 
give  the  children  but  little  uneasiness,  and  effectually  answered  my  intention  in  pre¬ 
venting  the  appearance  of  erysipelas.  Indeed,  it  seemed  to  do  more,  for  in  half  an 
hour  after  its  application,  the  indisposition  of  the  children  ceased.!  These  precautions 
were,  perhaps,  unnecessary,  as  the  arm  of,  the  third  child,  Mary  Pead,  which  was  suf¬ 
fered  to  take  its  common  course,  scabbed  quickly,  without  any  erysipelas. || 


CASE  XXIII. 

From  the  child’s  arm  matter  was  taken  and  transferred  to  that  of  J.  Barge,  a  boy  of 
seven  years  old.  He  sickened  on  the  eight  day,  went  through  the  disease  with  the 
usual  slight  symprtoms,  and  without  any  inflammation  on  the  aim  beyond  the  common 
efflorescence  surrounding  the  pustule,  and  appearance  so  often  seen  in  inoculated  small¬ 
pox. 

After  the  many  fruitless  attempts  to  give  the  small-pox  to  those  who  had  had  the 
cow-pox,  it  did  not  appear  necessary,  nor  was  it  convenient  to  me,  to  inoculate  the 
whole  of  those  who  had  been  the  subject  of  these  late  trials  ;  yet  I  thought  it  right  to 
see  the  effects  of  variolous  matter  on  some  of  them,  particularly  William  Summers,  the 
first  of  these  patients  who  had  been  infected  with  matter  taken  from  the  cow.  He  was 
therefore  inoculated  with  variolous  matter  from  a  fresh  pustule  ;  but,  as  in  the  preced¬ 
ing  cases,  the  system  did  not  feel  the  effects  of  it  in  the  smallest  degree.  I  had  an 
opportunity,  also,  of  having  this  boy  (Barge)  and  William  Pead  inoculated  by  my 
nephew,  Mr.  Henry  Jenner,  whose  report  to  mo  is  as  follows  :  “1  have  inoculated  Pead 

and  Barge,  two  of  the  boys  whom  you  lately  infected  with  the  cow-pox.  On  the 
second  day  the  incisions  were  inflamed,  and  there  was  a  pale,  inflammatory  stain 
around  them.  On  the  third  day  these  appearances  were  still  increasing,  and  their  arms 
itched  considerably.  On  the  fourth  day  the  inflammation  was  evidently  subsiding,  and 
on  the  sixth  it  was  scarcely  perceptible.  No  svmptom  of  indisposition  followed. 

“  To  convince  myself  that  the  variolous  matter  made  use  of  was  in  a  perfect  state,  I 
at  the  same  time  inoculated  a  patient  with  some  of  it  who  had  never  gone  through  the 
cow-pox,  and  it  produced  the  small-pox  in  the  usual  regular  manner.” 

These  experiments  afforded  me  much  satisfaction;  they  proved' that  the  matter,  in 
passing  from  one  human  subject  to  another,  through  five  gradations,  lost  none  of  its 

*This  was  not  done  intentionally,  but  from  the  accidental  touch  of  the  lancet,  one  puncture  being  always 
sufficient. 

IPerhaps  a  few  touches  with  the  lapis  septicus  would  have  proved  equally  efficacious. 

JWhat  effect  would  a  similar  treatment  produce  in  inoculation  for  the  small  pox  ? 

|| The  subsequent  part  of  this  treatise  will  sufficiently  show  the  proper  practice  in  cases  of  inflammation 
of  the  inoculated  arm. 


VARIOLA  VACCINtE. 


PLATE  18. 


Fig.  77:  Arm  of  John 
Baker;  Vaccinated 
March  16,  1798.  Plate  2 
Case  XVIII.  Inquiry t 
Edward  Jenner. 


9 


Fig.  78:  Arm  of  William 
Bead.  Case  XX.  Plate  3. 
Inquiry ,  Edward  Jenner 


Fig  79/  Arm  of  Hannah  Excell. 
Case  XXI.  Plate  No.  4.  In¬ 
quiry  into  Variolce  Vaccinrc. 
Edward  Jenner. 


™*n«w  OKKANS  UTH  C°  lOUAIOtlST 


Variola  Vaccince :  Edward  Jenner. 


23 


original  properties,  J.  Barge  being  the  fifth  who  received  the  infection  successively 
from  William  Summers,  the  boy  to  whom  it  was  communicated  from  the  cow. 

I  shall  now  conclude  this  inquiry  with  some  general  observations  on  the  subject,  and 
on  some  others  which  are  interwoven  with  it. 

Although,  I  presume,  it  maybe  unnecessary  to  produce  further  testimony  in  support 
of  rny  assertion  “‘that  the  cow-pox  protects  the  human  constitution  from  the  infection 
of  the  small-pox,”  yet  it  affords  me  considerable  satisfaction  to  say  that  Lord  Somer¬ 
ville,  the  president  of  the  Board  of  Agriculture,  to  whom  this  paper  was  shown  by  Sir 
Joseph  Banks,  has  found,  upon  inquiry,  that  the  statements  were  confirmed  by  the  con¬ 
curring  testimony  of  Mr.  Dollau,  a  surgeon,  who  resides  in  a  dairy  country  remote 
from  tins,  in  which  these  observations  were  made.  With  respect  to  the  opinion 
adduced  “that  the  source  of  the  infection  is  a  peculiar  morbid  matter  arising  in  the 
horse,”  although  I  have  not  been  able  to  prove  it  from  actual  experiments  conducted 
immediately  under  my  own  eye,  yet  the  evidence  I  have  adduced  appears  sufficient  to 
establish  it. 

They  who  are  not  in  the  habit  of  conducting  experiments  may  not  be  aware  of  the  co¬ 
incidence  of  circumstances  necessary  for  their  being  managed  so  as  to  prove  perfectly 
decisive  ;  nor  how  often  men  engaged  in  professional  pursuits  are  liable  to  interruptions 
which  disappoint  them  almost  at  the  instant  of  their  being  accomplished.  However,  I 
feel  no  room  for  hesitation  respecting  the  common  origin  of  the  disease,  being  well  con¬ 
vinced  that  it  never  appears  among  the  cows  (except  it  can  be  traced  to  a  cow  intro¬ 
duced  among  the  general  herd  which  has  been  previously  infected,  or  to  an  infected 
servant),  unless  they  have  been  milked  by  some  one  who,  at  the  same  time,  has  the  cai'e 
of  a  horse  affected  with  diseased  heels. 

The  spring  of  the  year  1797,  which  I  intended  particularly  to  have  devoted  to  the 
completion  of  this  investigation,  proved,  from  its  dryness,  remarkably  averse  to  my 
wishes  ;  for  it  frequently  happens,  while  the  farmer’s  horses  are  exposed  to  the  cold  rains 
which  fall  at  that  season,  that  their  heels  become  diseased,  and  no  cow-pox  then 
appeared  in  the  neighborhood. 

The  active  quality  of  the  virus  from  the  horse’s  heels  is  greatly  increased  after  it  has 
acted  on  the  nipples  of  the  cow,  as  it  rarely  happens  that  the  horse  affects  his  dresser 
with  sores,  and  as  rarely  that  a  milk  maid  escapes  the  infection  when  she  milks  infected 
cows.  It  is  most  active  at  the  commencement  of  the  disease,  even  before  it  has  acquired 
a  pus-like  appearance;  indeed,  I  am  not  confident  whether  this  property  in  the  matter 
does  not  entirely  cease  as  soon  as  it  is  secreted  in  the  form  of  pus.  I  am  induced  to 
think  it  does  cease*,  and  that  it  is  the  thin,  darkish-looking  fluid  only,  oozing  from  the 
newly  formed  cracks  in  the  heels,  similar  to  what  sometimes  appears  from  erysipelatous 
biisters,  which  gives  the  disease.  Nor  am  I  certain  that  the  nipples  of  the  cow  are  at 
all  times  in  a  state  to  receive  the  infection.  The  appearance  of  the  disease  in  the  spring 
and  the  early  part  of  the  summer,,  when  they  are  disposed  to  be  affected  with  spontane¬ 
ous  eruptions,  so  much  more  frequently  than  at  other  seasons,  induces  me  to  think  that 
the  virus  from  the  horse  must  be  received  upon  them  when  they  are  in  this  state,  in 
order  to  produce  effects.  Experiments,  however,  must  determine  these  points.  But  it 
is  clear  that  when  the  cow-pox  virus  is  once  generated  that  the  cows  cannot  resist  the 
contagion,  in  whatever  state  their  nipples  may  chance  to  be,  if  they  are  milked  with 
an  infected  hand. 

Whether  the  matter,  either  from  the  cow  or  the  horse,  will  affect  the  sound  skin  of 
the  human  body,  I  cannot  positively  determine;  probably  it  will  not,  unless  on  those 
parts  where  the  cuticle  is  extremely  thin,  as  on  the  lips,  for  example.  I  have  known  an 
instance  of  a  poor  girl  who  produced  an  ulceration  on  her  lip  by  frequently  holding  her 
finger  to  her  mouth  to  cool  the  raging  of  a  cow-pox  sore  by  blowing' upon  it.  The 
hands  of  the  farmer’s  servants  nere,  from  the  nature  of  their  employments,  are  con¬ 
stantly  exposed  to  those  injuries  which  occasion  abrasions  of  the  cuticle,  to  punctures 
from  thorns  and  such  like  accidents,  so  that  they  ai’e  always  in  a  state  to  feel  the  conse¬ 
quences  of  exposure  to  infectiov  s  matter. 

It  is  singular* to  observe  that  the  cow-pox  virus,  although  it  renders  the  constitution 
unsusceptible  of  the  variolous,  should,  nevertheless,  leave  it  unchanged  with  respect  to 
its  own  action.  I  have  already  produced  an  instance!  to  point  this  out,  and  shall  now 
corroborate  it  with  another. 

Elizabeth  Wynne,  who  had  the  cow-pox  in  the  year  1759,  was  inoculated  with  vario¬ 
lous  matter,  without  effect,  in  the  year  1797,  and  again  caught  the  cow-pox  in  the  year 
1798.  When  I  saw  her,  which  was  on  the  eighth  day  after  she  received  the  infection,  I 
found  her  affected  with  general  lassitude,  shiverings,  alternating  with  heat,  coldness 

*It  is  very  easy  to  procure  pus  from  old  sores  on  the  heels  of  horses.  This  I  have  often  inserted  into 
scratches  made  with  a  lancet,  on  the  sound  nipples  of  cows,  and  ha.ve  seen  no  other  effects  from  it  than 
simple  inflammation. 

tSee  case  IX. 


24 


Variolce  Vaccince  :  Edward  Jenner. 


oftlie  extremities,  and  a  quick  and  irregular  pulse.  These  symptoms  were  preceded  by 
a  pain  in  the  axilla.  On  her  hand  was  one  large,  pustulous  sore,  which  resembled  that 
delineated  in  plate  No.  1.* 

It  is  curious,  also,  to  observe  that  the  virus,  which,  with  respect  to  its  effects,  is  un¬ 
determined  and  uncertain  previously  to  its  passing  from  the  horse  through  the  medium 
of  the  cow,t  should  then  not  only  become  more  active,  but  should  invariably  and  com¬ 
pletely  possess  those  specific  properties  which  induce  in  the  human  constitution  symp¬ 
toms  similar  to  those  of  the  variolous  fever,  and  effect  in  it  that  peculiar  change  which 
forever  renders  it  unsusceptible  of  the  variolous  contagion. 

May  it  not  then  be  reasonably  conjectured  that  the  source  of  the  small-pox  is  morbid 
matter  of  a  peculiar  kind,  generated  by  a  disease  in  the  horse,  and  that  accidental  cir¬ 
cumstances  may  have  again  and  again  arisen,  still  working  new  changes  upon  it,  until 
it  has  acquired  the  contagious  and  malignant  form  under  which  we  now  commonly  see 
it  making  its  devastations  among  ns?  And,  from  a  consideration  of  the  change  which 
the  infections  matter  undergoes  from  producing  a  disease  ou  the  cow,  may  we  not  con¬ 
ceive  that  many  contagious  diseases  now  prevalent  amongst  us  may  owe  their  present 
appearance  not  to  a  simple,  but  to  a  compound,  origin  ?  For  example,  is  it.  difficult  to 
imagine  that  the  measles,  the  scarlet  fever,  and  the  ulcerous  sore  throat  with  a  spotted 
skin,  have  all  sprung  from  the  same  source,  assuming  some  variety  in  their  forms 
according  to  the  nature  of  their  new  combinations?  The  same  question  will  apply  re¬ 
specting  the  origin  of  many  other  contagious  diseases  which  bear  a  strong  analogy  to 
each  other. 

There  are  certainly  more  forms  than  one,  without  considering  the  common  variation 
between  the  confluent  and  distinct,  in  which  the  small-pox  appears  in  what  is  called  the 
natural  way.  About  seven  years  ago  a  species  of  small-pox  spread  through  many  of  the 
towns  and  villages  of  this  part  of  Gloucestershire.  It  was  of  so  mild  a  nature  that  a 
fatal  instance  was  scarcely  ever  heard  of,  and  consequently  so  little  dreaded  by  the 
lower  orders  of  the  community,  that  they  scrupled  not  to  hold  the  same  intercourse 
with  each  other  as  if  no  infectious  disease  had  been  present  among  them.  I  never  saw 
nor  heard  of  an  instance  of  its  being  confluent  The  most  accurate  manner,  perhaps, 
in  which  I  can  convey  an  idea  of  it  is,  by  saying,  that  had  fifty  individuals  been  taken 
promiscuously  and  infected  by  exposure  to  this  contagion,  they  would  have  had  as  mild 
and  light  a  disease  as  if  they  had  been  inoculated  with  variolous  matter  in  the  usual 
way.  The  harmless  manner  in  which  it  showed  itself' 'could  not  arise  from  any  peculiar¬ 
ity  either  in  the  season  or  the  weather,  for  I  watched  its  progress  upwards  of  a  year 
without  perceiving  any  variation  in  its  general  appearance.  I  consider  it,  then,  as  a 
variety  of  the  small-pox. j 

In  some  of  the  preceding  cases  I  have  noticed  the  attention  that  was  paid  to  the  state 
of  the  variolous  matter  previous  to  the  experiment  of  inserting  it  into  the  arms  of  those 
who  had  gone  through  the  cow-pox.  This  I  conceived, to  be  of  great  importance  in  con¬ 
ducting  these  experiments  and  were  it  always  properly  attended  to  by  those  who  inoc¬ 
ulate  for  the  small-pox,  it  might  prevent  much  subsequent  mischief  and  confusion. 
With  the  view  of  enforcing  so  necessary  a  precaution,  I  shall  take  the  liberty  of  digress¬ 
ing  so  far  as  to  point  out  some  unpleasant  facts,  relative  to  mismanagement  in  this  par¬ 
ticular,  which  have  fallen  under  my  own  observation. 

A  medical  gentleman  (now  no  more),  who,  for  many  years,  inoculated  in  this  neighbor¬ 
hood,  frequently  preserved  the  variolous  matter  intended  for  use,  on  a  piece  of  lint  or 
cotton,  which,  in  its  fluid  state,  was  put  into  a  vial,  corked  and  conveyed  into  a  warm 
pocket,  a  situation  certainly  favorable  for  speedily  producing  putrefaction  in  it.  In 
this  state  (not  (infrequently  after  it  had  been  taken  several  days  from  the  pustules'),  it 
was  inserted  into  the  arms  of  his  patients,  and  brought  on  inflammation  of  the  incised 
parts,  swellings  of  the  axillary  glands,  fever  and  sometimes  eruptions.  But  what  was 
this  disease  ?  Certainly  not  the  small-pox,  for  the  matter  having  from  putrefaction  lost 
or  suffered  a  derangement  in  its  specific  properties,  was  no  longer  capable  of  producing 
that  malady,  those  who  had  been  inoculated  in  this  manner  being  as  much  subject  to 
the  contagion  of  the  small-pox  as  if  they  had  never  been  under  the  influence  of  this 
artificial  disease;  and  many,  unfortunately,  fell  victims  to  it  who  thought  themselves 
in  perfect  security.  The  same  unfortunate  circumstance  of  giving  a  disease,  supposed 
to  be  the  small-pox,  with  inefficaceous  variolous  matter,  having  occurred  under  the 
direction  of  some  other  practitioners  within  my  knowledge,  and  probably  from  the 

*As  I  have  before  observed,  these  symptoms  probably  arose  from  the  irritation  of  the  sore,  which  was 
very  painful, 

t Further  explanation  will  be  adduced  on  this  subject. 

+My  friend,  Dr-  Hicks,  of  Bristol,  who,  during  the  prevalence  of  this  distemper,  was  resident  at  Glou¬ 
cester.  and  physician  to  the  hospital  there,  where  it  was  seen  soon  after  its  first  appearance  in  tl  is  coun¬ 
try,  had  opportunities  of  making  numerous  observations  upon  it,  which  it  is  his  intention  to  communicate  to 
the  public. 


YarioUv  Vaccina ?■ :  Edward  Jenner. 


2f> 


same  incautious  motbocl  of  securing  the  variolous  matter,  I  avail  myself  of  this  oppor¬ 
tunity  of  mentioning  what  I  conceive  to  be  of  great  importance,  and,  as  a  further  cau¬ 
tionary  bint,  I  shall  again  digress  so  far  as  to  add  another  observation  on  the  subject  of 
inoculation. 

Whether  it  be  yet  ascertained  by  experiment  that  the  quantity  of  variolous  matter 
inserted  into  the  skin  makes  any  difference  with  respect  co  the  subsequent  mildness  or 
violence  of  the  disease,  I  know  not ;  but  I  have  the  strongest  reason  for  supposing  that 
if  either  the  punctures  or  incisions  be  made  so  deep  as  to  go  through  it,  and  wound  the 
adipose  membrane,  that  the  risk  of  bringing  on  a  violent  disease  is  greatly  increased.  I 
have  known  an  inoculator,  whose  practice  was  “to  cut  deep  enough  (to  use  his  own 
expression)  to  see  a  bit  of  fat,”  and  there  to  lodge  the  matter.  The  great  number  of 
bad  cases,  independent  of  inff animations  and  abscesses  on  the  arms,  and  the  fatality 
which  attended  this  practice  was  almost  inconceivable,  and  I  cannot  account  for  it  on 
any  other  principle  than  that  of  the  matter  being  placed  in  this  situation  instead  of  the 
skin. 

It  was  the  practice  of  another,  whom  I  well  remember,  to  pinch  up  a  small  portion  of 
the  skin  on  the  arms  of  his  patients,  and  to  pass  through  it  a  needle,  with  a  thread 
attached  to  it,  previously  dipped  in  variolous  matter.  The  thread  was  lodged  in  the 
perforated  parts,  and  consequently  left  in  contact  with  the  cellular  membrane.  This 
practice  was  attended  with  the  same  ill  success  as  the  former.  Although  it  is  very  im¬ 
probable  that  any  one  would  now  inoculate  in  this  rude  way  by  design,  yet  these  ob¬ 
servations  may  tend  to  place  a  double  guard  over  the  lancet,  when  infants,  whose  skins 
are  comparatively  so  very  thin,  fall  under  the  care  of  the  inoculator. 

A  very  respectable  friend  of  mine,  Dr.  Hardwicke,  of  Sodbury,  in  this  county,  inocu¬ 
lated  great  numbers  ot  patients  px-evious  to  the  introduction  of  the  more  modern  method  by 
Sutton,  and  with  such  success  that  a  fatal  instance  occurred  as  rarsly  assince  that  method 
has  been  adopted  It  was  the  doctor’s  practice  to  make  as  slight  an  incision  as  possible 
upon  the  skin,  and  there  to  lodge  a  thread  saturated  with  the  variolous  matter.  When 
his  patients  became  indisposed,  agreeably  to  the  custom  thexx  prevailing,  they  were 
directed  to  go  to  bed,  and  wei'e  kept  moderately  warm.  Is  it  not  probable,  then,  that 
the  success  of  the  modern  practice  may  depend  more  upon  the  method  of  invariably  de¬ 
positing  the  virus  in  or  upon  tlxeskin  than  on  the  subsequent  treatment  of  the  disease  ? 

I  do  not  mean  to  insinuate  that  exposure  to  cool  air,  and  suffering  the  patient  to  drink 
cold  water  when  hot  and  thirsty,  may  not  moderate  the  eruptive  symptoms  and  lessen 
the  number  of  pustules  ;  yet,  to  repeat  my  former  observation,  I  cannot  account  for  the 
uninterrupted  success,  or  nearly  so,  of  one  practitioner,  and  the  wretched  state  of  the 
patients  under  the  care  of  another,  where,  in  both  instances,  the  general  treatment  did 
not  differ  essentially,  without  conceiving  it  to  arise  from  the  different  modes  of  inserting 
the  matter  for  the  purpose  of  producing  the  disease.  As  it  is  not  the  identical  matter 
inserted  which  is  absorbed  into  the  constitution,  but  that  which  is,  by  some  peculiar 
process  in  the  animal  economy,  generated  by  it,  is  it  not  probable  that  different  parts  of 
the  human  body  may  prepare  or  modify  the  vii’us  differently?  Although  the  shin,  for 
example,  adipose  membrane,  or  mucous  membranes,  are  all  capable  of  producing  the  va¬ 
riolous  virus  by  the  stimulous  given  by  the  particles  originally  deposited  upon  them,  yet 
I  am  induced  to  conceive  that  each  of  these  parts  is  capable  of  producing  some  variation 
in  the  qualities  of  the  matter  previous  to  its  affecting  the  constitution  What  else  can 
constitute  the  difference  between  the  small-pox  when  communicated  casually,  or  in 
what  has  been  termed  the  natural  way,  or  when  brought  on  artificially  through  the  me¬ 
dium  of  the  skin  ?  After  all  are  the  varioulous  particles,  possessing  their  true  specific 
and  contagious  principles,  ever  taken  up  and  conveyed  by  the  lymphatics  unchanged  into 
the  blood  vessels?  I  imagine  not.  Were  this  the  case,  should  we  not  find  the  blood 
sufficiently  loaded  with  them  in  some  stages  of  the  small-pox  to  communicate  the  disease 
by  inserting  it  under  the  cuticle,  or  by  spreading  it  on  the  surface  in  the  shape  of  an 
ulcer?  Yet  experiments  have  determined  the  impracticability  of  its  being  given  in  this 
way,  although  it  has  been  proved  that  variolous  matter,  when  much  diluted  with  water, 
and  applied  to  the  skin  in  the  nsual  manner,  will  produce  the  disease.  But  it  would  be 
digressing  beyond  a  proper  boundary  to  go  minutely  into  this  subject  here. 

At  what  period  the  cow-pox  was  first  noticed  here  is  not  upon  record.  Our  oldest 
•farmers  were  not  unacquainted  with  it  in  their  earliest  days,  when  it  appeared  among 
their  farms  without  any  deviation  from  the  phenomena  which  it  now  exhibits.  Its  con¬ 
nection  with  the  small-pox  seems  to  have  been  unknown  to  them.  Probably  the  gen¬ 
eral  introduction  of  inoculation  first  occasioned  the  discovei’y. 

Its  rise  in  this  country  may  not  have  been  of  very  remote  date,  as  the  practice  of  milk¬ 
ing  cows  might  formerly  have  been  in  the  hands  of  women  only,  which,  I  believe,  is  the 
case  now  in  some  other  dairy  countries,  and  consequently  that  the  cows  might  not  in 
former  times  have  been  exposed  to  the  coutagious  matter  brought  by  the  men  servants 
from  the  heels  of  horses.  Indeed,  a  knowledge  of  the  source  of  the  infection  is  new  ixx 


26 


Variola  Vaccina :  Edward  Jenner. 


the  minds  of  most  of  the  farmers  in  this  neighborhood,  but  has  at  length  produced  good 
consequences,  and  it  seems  probable  from  the  precautions  they  are  now  disposed  to  adopt 
that  the  appearance  of  the  cow-pox  here  may  either  be  entirely  extinguished  or  become 
extremely  rare. 

Should  it  be  asked  whether  this  investigation  be  a  matter  of  mere  curiosity,  or  whether 
it  tend  to  any  benetical  purpose,  I  should  answer  that,  notwithstanding  the  happy 
effects  of  inoculation,  with  all  the  improvements  which  the  practice  has  received  since 
its  first  introduction  into  this  country,  it  not  very  unfrequently  produces  deformity  of 
the  skin,  and  sometimes,  under  the  best  management,  proves  fatal. 

These  circumstances  must  naturally  create  in  every  instance,  some  degree  of  painful 
Solicitude  for  its  consequences.  But  as  I  have  neverknown  fatal  effects  arise  from  the  cow- 
pox,  even  when  impressed  in  the  most  unfavorable  manner,  producing  extensive  inflam¬ 
mations  and  suppurations  on  the  hands,  and  as  it  clearly  appears  that  this  disease  leaves 
the  constitution  in  a  state  of  perfect  security  from  the  infection  of  the  small-pox,  may 
Ave  not  infer  that  a  mode  of  inoculation  may  he  introduced  preferable  to  that  at  present 
adopted,  especially  among  those  families,  which,  from  previous  circumstances,  we  may 
judge  to  be  predisposed  to  have  the  disease  unfa  vorably  ?  It  is  an  excess  in  the  number 
of  pustules  which  we  chiefly  dread  in  the  small-pox;  but,  in  the  cow-pox,  no  pustules 
appear,  nor  does  it  seem  possible  for  the  contagions  matter  to  produce  the  disease  from 
effluvia,  or  by  other  means  than  contact,  and  that  probably  not  simply  between  the 
virus  and  the  cuticle,  so  that  a  single  individual  in  a  family  might  at  any  time  receive 
it  without  the  risk  of  infecting  the  rest,  or  of  spreading  a  distemper' that  fills  a  country 
with  terror.  Several  instances  have  coine  under  my  observation  which  justify  the  ' 
assertion  that  the  disease  cannot,  be  propagated  by  effluvia.  The  first  boy  whom  I  inocu¬ 
lated  with  the  matter  of  cow-pox  slept  in  a  bed,  while  the  experiment  was  going  for¬ 
ward,  with  two  children  who  never  had  gone  either  through  that  disease  or  the  small¬ 
pox  without  infecting  either  of  them. 

A  young  woman  who  had  the  cow-pox  to  a  great  extent,  several  sores  which  maturated 
having  appeared  on  the  hands  and  wrists,  slept  in  the  same  bed  with  a  fellow  dairy  maid 
who  never  had  been  infected  Avith  either  the  cow-pox  or  the  small-pox,  but  no  indisposi¬ 
tion  followed. 

Another  instance  has  occurred  of  a  young  woman  on  whose  hands  Avere  several  large 
suppurations  from  the  cow-pox,  who  was  at  the  same  time  a  daily  nurse  to  an  infant, 
but  the  complaint  was  not  communicated  to  the  child 

In  some  other  points  ot  view  the  inoculation  of  this  disease  appears  preferable  to  the 
variolous  inoculation. 

In  constitutions  predisposed  to  scrofula  how  frequently  Ave  see  the  inoculated  small-pox 
rouse  into  activity  that  distressful  malady.  This  circumstance  does  not  seem  to  depend 
on  the  manner  in  which  the  distemper  has  shown  itself,  for  it  has  as  frequently  hap¬ 
pened  among  those  xvho  have  had  it  mildly  as  when  it  appeared  in  the  contrary  way. 

There  are  many  who,  from  some  peculiarity  in  tlu^  habit,  resist  the  common  effects  of 
variolous  matter  inserted  into  the  skin,  and  who  are  in  consequence  haunted  through 
life  with  the  distressing  idea  of  being  insecure  from  subsequent  infection.  A  ready 
mode  of  dissipating  anxiety  originating  from  such  a  cause  must  now  appear  obvious. 
And,  as  we  have  seen  that  the  constitution  may  at  any  time  be  made  to  feel  the  febrile 
attack  of  cow-pox,  might  it  not,  in  many  chronic  diseases,  be  introduced  into  the  sys¬ 
tem,  with  the  probability  of  affording  relief  upon  well  known  physiological  principles 

Although  I  say  the  system  may  at  any  time  be  made  to  feel  the  febrile  attack  of  coav- 
pox,.  yet  I  have  a  single  instance  before  me  where  the  virus  acted  locally  only,  but  it  is 
not  in  the  least  probable  that  the  same  person  would  resist  the  action  both  of  the  cow- 
pox  virus  and  the  variolous. 

Elizabeth  Sarsenet  lived  as  a  dairy  maid  at  Newpark  farm,  in  this  parish.  All  the 
cows  and  the  servants  employed  in  milking  had  the  cow-pox,  but  this  woman,  though 
she  had  several  sores  upon  her  fingers,  felt  no  tumors  in  the  axilla,  nor  any  general  in¬ 
disposition.  On  being  afterwards  casually  exposed  to  variolous  infection  she  had  the 
small-pox  m  a  mild  way.!  % 

Hannah  Pick,  another  of  the  dairy  maids,  who  was  a  fellow  servant  with  Elizabeth 
Sarsenet,  when  the  distemper  broke  out  at  the  farm,  was  at  the  same  time  infected,  but 
this  young  woman  had  not  only  sores  upon  her  hands,  but  felt  herself  also  much  indis¬ 
posed.  for  a  day  or  two.  After  this,  I  made  several  attempts  to  give  her  the  small-pox  by 
inoculation,  but  they  all  proved  fruitless.  From  the  former  case,  then,  we  see  that  the 
animal  economy  is  subject  to  the  same  laws  in  one  disease  as  the  other. 

The  following  case,  which  lias  very  lately  occurred,  renders  it  highly  probable  that 
not  only  the  heels  of  the  horse,  but  other  parts  of  the  body  of  that  animal,  are  capable 
of  generating  the  virus  which  produces  the  cow-pox. 

-Inoculation  in  a  common  way  upon  the  arm  Avill  seldom  produce  this  effect.  When  the  disease  takes 
place  among  the  dairy  people,  the  virus  conies  in  contact  with  pro-existing  sores,  which  does  not  fail  to 
produce  an  irritation  that  affects  the  system  generally. 

tThia  will  be  more  satisfactorily  explained  in  the  sequel. 


27 


Variola]  Vaccina’ :  Edward  Jenner. 


An  extensive  inflammation  of  the  erysipelatous  kind  appeared  without  any  apparent 
cause  upon  the  upper  part  of  the  thigh  of  a  sucking  col',  the  proport v  of  Mr.  Millet,  a 
farmer  at  Rockhampton,  a  village  near  Berkeley.  The  inflammation  continued  several 
weeks,  and  at  length  terminated  in  the  formation  of  three  or  four  small  abscesses.  The 
inflamed  parts  were  fomented  and  dressings  were  applied  by  some  of  the  same  persons 
who  were  employed  in  milking  the  cows.  The  number  of  cows  milked  was  twenty-four, 
and  the  whole  of  them  had  the  cow-pox.  The  milkers,  consisting  of  the  farmer’s  wife,  a 
man  and  a  maid  servant,  were  infected  by  the  cows.  The  man  servant  had  previously 
gone  through  the  small-pox,  and  felt  but  little  of  the  cow-pox.  The  servant  maid  had 
some  years  before  been  infected  with  the  cow-pox,  and  she  also  felt  it  now  in  a  slight 
degree.  But  the  farmer’s  wife,  who  never  had  gone  through  either  of  these  diseases, 
felt  its  effects  very  severely. 

That  the  disease  produced  upon  the  cows  by  the  colt,  and  from  thence  conveyed  to 
those  who  milked  them,  was  the  true  and  not  the  spurious  cow-pox  there  can  be 
scarcely  any  room  for  suspicion;  yet  it  would  have  been  completely  satisfactory  had 
the  effects  of  variolous  matter  been  ascertained  on  the  farmer’s  wife,  but  there  was  a 
peculiarity  in  her  situation  which  prevented  my  making  the  experiment. 

Thus  far  have  1  proceeded  in  an  enquiry,  founded,  as  it  must  appear,  on  the  basis  of 
experiment,  in  which,  however,  conjecture  ha, s  been  occasionally  admitted,  in  order  to 
present  to  persons  well  situated  for  such  discussions,  objects  for  a  more  minute  investi¬ 
gation.  In  the  meantime,  I  shall  myself  continue  to  prosecute  this  inquiry,  encour¬ 
aged  by  the  pleasing  hope  of  its  becoming  essentially  beneficial  to  mankind. 


FURTHER 


ON  THE 


TABIOL.E  'VA-COUCsTJE. 


ADVERTISEMENT. 


Tlie.  foregoing  pages  contain  tlie  whole  of  my  first  treatise  on  the  “  Variohe  Vaccinai,” 
published  in  June,  1798.  The  importance  of  the  inquiry  to  the  whole  human  race  nat¬ 
urally  excited  universal  attention.  Ingenuity  and  industry  were  set  in  motion,  but  as 
physiological  discussions  are  ever  liable  to  error,  from  the  complicated  nature  of  their 
character,  I  soon  clearly  perceived  that  this  theory,  so  beneficial  to  mankind,  was  liable  to 
fall  into  disrepute,  and  to  be  wholly  discredited  by  the  hasty  conclusions  unfounded  on 
experiment. 

To  guard  the  public  mind  from  prejudice,  and  to  enforce  the  necessity  of  a  scrupulous 
precaution  in  the  conduct  of  inoculation  with  vaccine  matter,  I  was  induced  to  offer  to 
the  world  “  Further  Observations”  on  the  disease,  which  werepublished  in  the  beginning 
of  the  year  1799.  These  treatises  I  have  here  combined,  together  with  some  additions 
which  the  continuance  of  the  enquiry  has  enabled  me  to  submit  to  the  public. 


FURTHER  OBSERVATIONS,  &0.,  &C. 


Although  it  has  not  been  iu  my  power  to  extend  the  inquiry  into  the  causes  and  effects 
of  the  Variohe  Vaccime  much  beyond  its  original  limits,  yet,  perceiving  that  it  is  be- 
ginningto  excite  a  general  spirit  of  investigation,  I  thiuk  it  of  importance,  without  de¬ 
lay,  to  communicate  such  facts  as  have  since  occurred,  and  to  point  out  the  fallacious 
sources  from  whence  a  disease  resembling  the  true  variolas  vaccinm  might  arise,  with  the 
view  of  jireventing  those  who  may  inoculate  from  producing  a  spurious  disease;  and, 
further,  to  enforce  the  precaution  suggested  in  the  former  treatise  on  the  subject,  of  sub¬ 
duing  the  inoculated  pustule  as  soon  as  it  has  sufficiently  produced  its  influence  on  the 
constitution.  From  a  want  of  due  discrimination  of  the  real  existence  of  the  disease, 
either  in  the  brute  or  in  the  human  subject,  aud  also  of  that  stage  of  it  in  which  it  is 
capable  of  producing  the  change  in  the  animal  economy,  which  renders  it  unsusceptible 
of  the  cantagiou  of  the  small-pox,  uupleasaut  consequences  might  ensue,  the  source  of 
which,  perhaps,  might  not  be  suspected  by  one  inexperienced  in  conducting  such  experi¬ 
ments. 

My  late  publication  contains  a  relation  of  most  of  the  facts  which  had  come  under  my 
owu  inspection  at  the  time  it  was- written,  interspersed  with  some  conjectural  observa¬ 
tions.  Since  then,  Dr.  G.  Pearson  has  established  an  inquiry  into  the  validity  of  my 
principal  assertion,  the  result  of  which  cannot  but  be  highly  flattering  to  my  feelings. 
It  contains  not  a  single  case  which  I  think  can  be  called  an  exception  to  the  tact  I  was 
so  firmly  impressed  with — that  the  cow-pox  protects  the  human  body  from  the  small¬ 
pox.  I  have  myself  received  some  further  confirmations,  which  shall  he  subjoined.  1 
have  lately  also  been  favored  with  a  letter  from  a  gentleman  of  great  respectability 
(Dr.  Ingenhousz)  informing  me  that,  on  making  an  inquiry  into  the  subject  in  the  couuty 
of  Wilts,  he  discovered  that  a  farmer  near  Caine  had  been  infected  with  the  small-pox 
after  having  had  the  cow-pox,  aud  that  the  disease  iu  each  instance  was  so  strongly 
characterized,  as  to  render  the  facts  incontrovertible.  The  cow-pox,  it  seems,  from  the 
doctor’s  information,  was  communicated  to  the  farmer  from  his  cows,  at  the  time  that 
they  gave  out  an  offensive  stench  from  their  udders. 


32 


Variola ?  Vaccina  :  Edward  Jenner. 


Some  other  instances  liave  likewise  been  represented  to  me  of  the  appearance  of  the 
disease,  apparently  marked  with  its  characteristic  symptoms,  and  yet  that  the  patients 
have  afterwards  had  the  small-pox.  On  these  cases  I  shall,  for  the  present,  suspend  any 
particular  remarks,  hut  hope  that  the  general  observations  I  have  to  offer  in  the  sequel 
will  prove  of  sufficient  weight  to  render  the  idea  of  their  ever  having  had  existence  but 
as  cases  of  spurious  cow-pox  extremely  doubtful. 

Ere  I  proceed,  let  me  be  permitted  to  observe  that  truth,  in  this  and  every  other  phy¬ 
siological  inquiry  that  has  occupied  my  attention,  has  ever  been  the  object  of  my  pur¬ 
suit;  and  should  it  appear  in  the  present  instance  that  I  have  been  led  into  error,  fond 
as  I  may  appear  of  the  offspring  of  my  labors,  I  had  rather  see  it  perish  at  once  than 
exist  and  do  a  public  injury, 

I  shall  proceed  to  enumerate  the  sources,  or  what  appear  to  me  as  such,  of  a  spurious 
cow-pox : 

Firstly. — That  arising  from  pustules  on  the  nipples  or  udder  of  the  cow,  which  pustules 
contain  no  specific  virus. 

Secondly. — From  matter,  although  originally  possessing  the  specific  virus,  which  has 
suffered  a  decomposition,  either  from  putrefaction  or  from  any  other  cause  less  obvious 
to  the  senses. 

Thirdly. — From  matter  taken  from  an  ulcer  in  an  advanced  stage,  which  ulcer  arose 
from  a  true  cow-pock. 

Fourthly. — From  matter  produced  on  the  human  :sk i n  from  contact  with  some  peculiar 
morbid  matter  generated  by  a  horse. 

On  these  subjects  I  shall  offer  some  comments.  First — To  what  length  pustulous  dis¬ 
eases  of  the  udder  and  nipples  of  the  cow  may  extend,  it  is  not  in  my  power  to  deter¬ 
mine  ;  but  certain  it  is  that  these  parts  of  the  animal  are  subject  to  some  variety  of 
maladies  of  this  nature;  and  as  many  of  these  eruptions,  propably  all  of  them,  are 
capable  of  giving  a  disease  to  the  human  body,  would  it  not  be  discreet  for  those  en¬ 
gaged  in  this  investigation  to  suspend  controversy  and  cavil  until  they  can  ascertain 
with  precision  what  is  and  what  is  not  the  genuine  cow  pox  ? 

For  example,  a  farmer  who  is  not  conversant  with  any  of  these  maladies,  but  who 
may  have  heard  of  the  cow-jiox  in  general  terms,  may  acquaint  a  neighboring  surgeon 
that  the  distemper  appears  at  his  farm.  The  surgeon,  eager  to  make  an  experiment, 
takes  away  matter,  inoculates,  produces  a  sore,  uneasiness  in  the  axilla,  and  perhaps 
some  affection  of  the  system.  This  is  a  way  in  which  a  fallacious  idea  of  security,  both 
in  the  mind  of  the  inoculator  and  the  patient,  may  arise,  for  a  disease  may  thus  have 
been  propagated  from  a  simple  eruption  only. 

One  of  the  first  objects,  then,  of  this  pursuit,  as  I  have  observed,  should  be  to  learn 
how  to  distinguish  with  accuracy  between  that  peculiar  pustule  which  is  the  true  cow- 
pock,  and  that  which  is  spurious.  Until  experience  has  determined  this,  we  view  our 
object  through  a  mist.  Let  us,  for  instance,  suppose  that  the  small-pox  and  the 
chicken-pox  were  at  the  same  time  to  spread  among  the  inhabitants  of  a  country  which 
had  never  been  visited  by  either  of  these  distempers,  and  where  they  were  quite  un¬ 
known  before.  What  confusion  would  arise !  The  resemblance  between  the  symptoms 
of  the  eruptive  fever,  and  between  the  pustules,  in  either  case  would  be  so  striking 
that  a  patient  who  had  gone  through  the  chicken-pox  to  any  extent  would  feel  equally 
easy  with  regard  to  his  future  security  from  the  small-pox,  as  the  person  who  had 
actually  passed  through  that  disease.  Time  and  future  observation  would  draw  the 
line  of  distinction. 

So,  I  presume,  it  will  be  with  the  cow-pox,  until  it  is  more  generally  understood.  All 
cavilling,  therefore,  on  the  mere  report  of  those  who  tell  us  they  have  had  this  distem¬ 
per,  and  are  afterwards  found  to  be  susceptible  of  the  small-pox,  should  be  suspended. 
To  illustrate  this,  I  beg  leave  to  give  the  following  history  : 

Sarah  Merlin,  of  the  parish  of  Easington,  in  this  county,  when  about  thirteen  or  four¬ 
teen  years  of  age,  lived  as  a  servant  with  farmer  Clarke,  who  kept  a  dairy,  consisting  of 
about  eighteen  cows,  at  Stonehouse,  a  neighboring  village.  The  nipples  and  udders  of 
three  of  the  cows  were  extensively  affected  with  large  white  blisters.  These  cows  the 
girl  milked  daily,  and,  at  the  same  time,  she  assisted,  with  two  others,  m  milking  the 
rest  of  the  herd.  It  soon  appeared  that  the  disease  was  communicated  to  the  girl.  The 
rest  of  the  cows  escaped  the  infection,  although  they  were  milked  several  days  after  the 
three  above  specified  had  these  eruptions  on  their  nipples  and  udders,  and  even  after  the 
girl’s  hand  became  sore.  The  two  others  who  were  engaged  in  milking,  although  they 
milked  the  cows  indiscriminately,  received  no  injury.  On  the  fingers  of  each  of  the 
girl’s  hands  there  appeared  several  large  white  blisters,  she  supposes  about  three  or  four 
on  each  finger.  The  hands  and  arms  inflamed  and  swelled,  but  no  constitutional  indis¬ 
position  followed.  The  sores  were  anointed  with  some  domestic  ointment,  and  got  well 
without  ulcerating. 


Variola  Vaccina  :  Edward  Jenner. 


33 


As  this  malady,  was  called  the  cow-pox.  and  recorded  as  such  in  the  mind  of  the  pa¬ 
tient,  she  became  regardless  of  the  small-pox;  but,  on  being  exposed  to  it  some  years 
afterwards,  she  was  iufected,  and  had  a  full  burthen. 

Now,  had  any  one  conversant  with  the  habits  of  the  disease  heard  this  history,  they 
would  have  had  no  hesitation  in  pronouncing  it  a  case  of  spurious  cow-pox ;  considering 
its  deviation  in  the  numerous  blisters  which  appeared  on  the  girl’s  hands;  their  termina¬ 
tion  without  ulceration  ;  its  not  proving  more  generally  contagious  at  the  farm,  either 
among  the  cattle  or  those  employed  in  milking;  and  considering  also  that  the  patient 
felt  no  general  indisposition,  although  there  was  so  great  a  number  of  vessicles. 

This  is  perhaps  the  most  deceptions  form  in  which  an  eruptive  disease  can  be  commu¬ 
nicated  from  the  cow,  and  it  certainly  requires  some  attention  in  discriminating  it.  The 
most  perfect  criterion  by  which  the  judgment  may  be  guided,  is,  perhaps,  that  adopted 
by  those  who  attend  infected  cattle.  These  white  blisters  on  the  nipples,  they  say, 
never  eat  into  the  fleshy  parts  like  those  which  are  commonly  of  a  bluish  cast,  and  which 
constitute  the  true  cow-pox,  but  that  they  afl'ect  the  skin  only,  quickly  end  in  scabs,  and 
are  not  nearly  so  infectious. 

That  which  appeared  to  me  as  one  cause  of  spurious  eruptions,  I  have  already  re¬ 
marked  in  a  former  treatise,  namely,  the  transition  that  the  cow  makes  in  the  spring 
from  a  poor  to  a  nutritious  diet,  and  from  the  udders  becoming  at'  this  time  more  vascu¬ 
lar  than  usual  for  the  supply  of  milk.  But  there  is  another  source  of  inflammation  and 
pustules,  which  I  believe  is  not  uncommon  in  all  the  dairy  counties  in  the  west  of 
England.  A  cow  intended  to  be  exposed  for  sale,  having  naturally  a  small  udder,  is 
previously,  for  a  day  or  two,  neither  milked  artificially  nor  is  her  calf  suffered  to  have 
access  to  her.  Thus  the  milk  is  preternatural ly  accumulated,  and  the  udder  and  nip¬ 
ples  become  greatly  distended.  The  consequences  frequently  are  inflammations  and 
eruptions,  which  maturate. 

Whether  a  disease  generated  in  this  way  has  the  power  of  affecting  the  constitution  in 
any  peculiar  manner,  I  cannot  presume  posi i  ively  to  determine.  It  has  been  conjectured 
to  have  been  a  cause  of  the  true  cow-pox,  though  my  inquiries  have  not  led  me  to  adopt 
this  supposition  in  any  one  instance.  On  the  contrary,  I  have  known  the  milkers  af¬ 
fected  by  it,  but  always  found  that  an  affection  thus  induced  left  the  system  as  suscepti¬ 
ble  of  the  small-pox  as  before. 

What  is  advanced  in  my  second  position,  I  consider  also  of  very  great  importance,  and 
I  could  wish  it  to  be  strongly  impressed  on  the  minds  of  all  who  may  be  disposed  to  con¬ 
clude  hastily  on  my  observations,  whether  engaged  in  their  investigation  by  experi¬ 
ments  or  not.  To  place  this  in  its  clearest  point  of  view  (as  the  similarity  between  the 
action  of  the  small-pox  and  the  cow-pox  matter  is  so  obvious),  it  will  be  necessary  to 
consider  what  we  sometimes  observe  to  take  place  in  inoculation  for  the  small-pox  when 
imperfect  variolous  matter  is  made  use  of.  The  concise  history  on  this  subject  that  was 
brought  forward  respecting  what  I  had  observed  in  this  neighborhood,*  I  perceive  by 
a  reference  since  made  to  the  Memoirs  of  the  Medical  Society  of  Loudon,  may  be  consid¬ 
ered  as  no  more  than  a  corroboration  of  the  facts  very  clearly  detailed  by  Mr.  Kite.) 
To  this  copious  evidence  I  have  to  add  still  more  in  the  following  communications  from 
Mr.  Earle,  surgeon,  of  Frampton-upon-Severn,  in  this  county,  which  I  deem  the  more 
valuable,  as  he  has,  with  much  candor,  permitted  mo  to  make  them  public: 

‘‘Sir— I  have  read  with  satisfaction  your  late  publication  on  the  Variolie  VacCinai, 
and  being,  among  many  other  curious  circumstances,  particularly  struck  with  that  re¬ 
lating  to  the  inefficacy  of  small-pox  matter  in  a  particular  state.  I  think  it  proper  to  lay 
before  you  the  following  facts,  which  came  within  my  own  knowledge,  and  which  cer¬ 
tainly  tend  to  strengthen  the  opinions  advanced  in  pages  51  and  52  of  your  treatise. 

“ In  March,  1784,  a  general  inoculation  took  place  at  Arlingham,  in  this  county,  I 
inoculated  several  patients  with  active  variolous  matter,  all  of  whom  had  the  disease  in 
a  favorable  way ;  but  my  matter  being  all  used,  and  not.  being. able  to  procure  any  more 
in  the  state  I  wished,  I  was  under  the  necessity  of  taking  it  from  a  pustule  which, 
experience  has  since  proved,  wj$s  advanced  too  far  to  answer  the  purpose  I  intended.  Of 
five  persous  inoculated  with  this  last  matter,  four  took  the  small-pox  afterwards  in  the 
natural  way  ;  oue  of  whom  died,  three  recovered,  and  the  other,  being  cautioned  by  me 
to  avoid  as  much  as  possible  the  chance  of  catching  it,  escaped  from  the  disease  through 
life.  He  died  of  another  disorder  about  two  years  ago. 

“Although  one  of  these  cases  ended  unfortunate,  yet  I  cannot  suppose  that  any  medi¬ 
cal  man  will  think  me  careless  or  inattentive  in  their  management;  fori  conceive  the 
appearances  were  such  as  might  have  induced  any  one  to  suppose  that  the  persons  were 
perfectly  safe  from  future  infection.  Inflammation  in  every  case  took  place  in  the  arm, 
and  fever  came  on  with  a  considerable  degree  of  pain  in  the  axilla.  In  some  of  their 
arms  the  inflammation  and  suppuration  were  more  violent  than  is  commonly  observed 

*An  inquiry  into  the  causes  and  effects  of  the  Variola;  Vaccin®. 

tSee  an  account  of  some  anomalous  appearances  subsequent  to  the  inoculation  of  the  small-pox,  by 
Charles  Kite,  surgeon,  of  Gravesend,  in  the  memoirs  of  the  Medical  Society  of  London.  Vol.  IV.,  page  111. 


34 


Variolce  Vaccinal :  Edward  Jenner. 


when  perfect  matter  is  made  use  of ;  in  one  there  was  an  ulcer  which  cast'  off  several 
large  sloughs  About  the  ninth  day  eruptions  appeared,  which  died  away  earlier  than 
common  without  maturation.  From  these  circumstances  I  should  suppose  that  no  med¬ 
ical  practitioner  would  scarcely  have  entertained  a  doubt  that  these  patients  had  been 
infected  with  a  true  small-pox;  yet  I  must  confess  that  some  small  degree  of  doubt  pre¬ 
sented  itself  to  me  at  the  speedy  disappearance  of  the  eruptions  ;  and  in  order,  as  far  as 
I  could,  to  ascertain  their  safety,  I  sent  one  of  them  to  a  much  older  practitioner  than 
myself.  This  gentleman,  on  hearing  the  circumstance  of  the  case,  pronounced  the  pa¬ 
tient  perfectly  secure  from  future  infection. 

“  The  following  facts  are  also  a  striking  proof  of  the  truth  of  your  observations  on  this 
subject : 

“  In  the  year  1789  I  inoculated  three  children  of  Mr.  Coaley,  of  Hurst-farm,  in  this 
county.  The  arms  inflamed  properly,  fever  and  pain  in  the  axilla  came  on  precisely  the 
same  as  in  the  former  cases,  and  in  ten  days  eruptions  appeared,  which  disappeared  in 
the  course  of  two  days  I  must  observe  that  the  matter  here  made  use  of  was  procured  for 
me  by  a  friend,  but  no  doubt  it  was  in  an  improper  state;  for,  from  the  similarity  of  these 
cases  to  those  which  happened  at  Arlingliam  five  years  before,  I  was  somewhat  alarmed 
for  their  safety,  and  desired  to  inoculate  them  again  ;  which  being  permitted,  1  was 
particularly  careful  to  procure  matter  in  its -most  perfect  state.  All  the  children  took 
the  small-pox  from  this  second  inoculation,  and  all  had  a  very  full  burthen.  These  facts 
I  conceive  strikingly  corroborate  your  opinion  relative  to  the  different  states  of  matter; 
for  in  both  the  instances  that  I  have  mentioned  it  was  capable  of  producing  something 
strongly  resembling  the  true  small-pox,  although  it  afterwards  proved  not  to  be  so 

“As  I  think  the  communication  of  these  cases  is  a  duty  1  owe  to  the  public,  you  are  at 
liberty  to  make  what  use  you  please  of  this  letter.  1  remain,  etc., 

JOHN  EARLE.” 

Frampton-upon-Severn,  Gloucestershire,  November  10,  1798. 

“  P.  S. — I  think  it  necessary  to  observe,  that  lean  pronounce  with  the  greatest  cer¬ 
tainty,  that  the  matter  wi f  h  which  the  Arlingham  patients  were  inoculated  was  taken 
from  a  true  small-pox  pustule.  I  took  it  myself  from  a  subject  that  had  a  very  full 
burthen.” 

Certain  then  it  is  that  variolous  matter  may  undergo  such  a  change  from  the  putrefac¬ 
tive  process,  as  well  as  from  some  of  the  more  obscure  and  latent  processes  of  nature,  as 
will  render  it  incapable  of  giving  the  small-pox  in  such  a  manner  as  to  secure  the  human 
constitution  from  future  infection,  although  we  see  at  the  same  time  it  is  capable  of 
exciting  a  disease  which  bears  so  strong  a.  resemblance  to  it  as  to  produce  inflammation 
and  matter  in  the  incised  skin  (frequently,  indeed,  more  violent  than  wlien  it  produces 
its  effects  perfectly),  swelling  of  the  axillary  glands,  general  indisposition  and  eruptions. 
So  strongly  persuaded  was  the  gentleman,  whose  practice  I  have  mentioned  in  page  51 
of  the  late  Treatise,  that  he  could  produce  a,  mild  small-pox  by  his  mode  of  managing 
the  matter,  that  he  spoke  of  it  as  a  useful  discovery,  until  eonviuced  of  his  error  by  the 
fatal  consequence  which  ensued. 

After  this  ought  we  to  be  in  the  smallest  degree  surprised  to  find,  among  a  great  num¬ 
ber  of  individuals,  who,  by  living  in  dairies,  have  been  casually  exposed  to  the  cow-pox 
virus,  when  in  a  state  analogous  to  that  of  the  small-pox  above  described,  some  who 
may  have  had  the  disease  so  imperfectly  as  not  to  render  them  secure  from  variolous 
attacks?  For  the  matter,  when  burst  from  the  pustules  on  the  nipples  of  the  cow,  by 
being  exposed,  from  its  lodgment  there,  to  the  heat  of  an  inflamed  surface,  and  from  be¬ 
ing,  at  the  same  time,  in  a  situation  to  be  occasionally  moistened  with  milk,  is  often 
likely  to  be  in  a  state  conducive  to  putrefaction  ;  and  thus,  under  some  modification  of 
decomposition,  it  must,  of  course,  sometimes  find  access  to  the  hand  of  the  milker  in 
such  a  way  as  to  infect  him.  What  confusion  should  we  have  were  there  no  other 
mode  of  inoculating  the  small-pox  than  such  as  would  happen  from  handling  the 
diseased  skin  of  a  person  laboring  under  that  distempe^in  some  of  its  advanced  and 
loathsome  stages !  It  must  be  observed  that  every  case  of  small-pox  in  the  human 
species,  whether  communicated  by  design  or  otherwise,  is  to  be  considered  as  a  case  of 
inoculation.  And  here  I  may  be  allowed  to  make  an  observation  on  the  case  of  the 
farmer,  communicated  to  me  by  Dr.  Ingcnhousz.  That  he  was  exposed  to  the  matter 
when  it  had  undergone  the  putrefactive  change,  it  is  highly  probable,  from  the  doctor’s 
observing  that  the  sick  cows  at  the  farm  gave  out  an  offensive  stench  from  the  udders. 
However,  I  must  remark,  that  it  is  unusual  for  cattle  to  suffer  to  such  an  extent,  when 
disordered  with  the  cow-pox,  so  as  to  make  a  by-stander  sensible  of  ’  any  ill  smell.  I 
have  often  stood  among  a  herd  which  had  the  distemper,  without  being  conscious  of  its 
presence  from  any  particular  effluvia.  Indeed,  in  this  neighborhood  it  commonly  re¬ 
ceives  an  early  check  from  escharotic  applications  of  the  cow  leech.  It  has  been  con¬ 
ceived  to  be  contagious  among  cows  without  contact ;  but  this  idea  cannot  be  well- 
founded,  because  the  cattle  in  one  meadow  do  not  affect  those  in  another  (although 


Variolcv  Vaccince  :  Edward  Jenner. 


35 


tliere  may  be  no  other  partition  than  a  hedge),  unless  they  be  handled  or  milked  by 
those  who  bring  the  infectious  matter  with  them  ;  and,  of  course,  the  smallest  particle 
imaginable,  when  applied  to  a  part  susceptible  of  its  influence,  may  produce  the  effect. 
Among  the  human  species  it  appears  to  be  very  clear  that  the  disease  is  produced  by 
contact  only.  All  my  attempts,  at  least,  to  communicate  it  by  effluvia  have  hitherto 
proved  ineffectual. 

As  well  as  the  perfect  change  from  that  state  in  which  variolous  matter  is  capable  off 
producing  full  and  decisive  effects  on  the  constitution,  to  that  wherein  its  specific  prop¬ 
erties  are  entirely  lost,  it  may  reasonably  be  supposed  that  it  is  capable  of  undergoing  a 
variety  of  intermediate  changes.  The  following  singular  occurrences  in  ten  cases  of  in¬ 
oculation,  obligingly  communicated  to  me  by  Mr.  Trye,  senior  surgeon  to  the  infimary  at 
Gloucester,  seem  to  indicate  that  the  variolous  matter,  previously  to  its  being  taken 
from  the  patient  for  the  intended  purpose,  was  beginning  to  part  with  some  of  its  orig¬ 
inal  properties;  or,  in  other  words,  that  it  had  suffered  a  partial  decomposition.  Mi’. 
Trye  says:  “Ii  noculated  ten  children  with  matter  taken  at  one  time  and  from  the 
same  subject.  I  observed  no  peculiarity  in  any  of  them  previously  to  their  inoculation, 
m>r  did  anything  remarkable  appear  in  their  arms  till  after  the  decline  of  the  disease. 
Two  infants  of  three  months  old  had  erysipelas  about  the  incisions,  in  one  of  them  ex¬ 
tending  from  the  shoulders  to  the  finger’s  ends.  Another  infant  had  abscesses  in  the 
cellular  substance  in  the  neighborhood  of  the  incisions,  and  tive  or  six  of  the  rest  had 
axillary  abscesses.  The  matter  was  taken  from  the  distinct  small-pox  late  in  its  pro¬ 
gress,  and  when  some  pustules  had  been  dried.  It  was  received  upon  glass,  and  slowly 
dried  by  the  tire.  All  the  children  had  pustules  which  maturated,  so  that  I  suppose 
them  all  secure  from  future  infection  ;  at  least,  as  secure  as  any  others  whom  I  have 
ever  inoculated.  My  practice  never  afforded  a  sore  arm  before.” 

In  regard  to  my  former  observation  on  the  improper  and  dangerous  mode  of  preserving 
variolous  matter,  I  shall  here  remark  that  it  seems  not  to  have  been  clearly  understood. 
Finding  that  it  has  been  confounded  with  the  more  eligible  modes  of  preservation,  I  will 
explain  myself  further.  When  the  matter  is  taken  from  a  tit  pustule,  and  properly  pre¬ 
pared  for  preservation,  it  may  certainly  be  kept  without  losing  its  specific  properties  a 
great  length  of  time  ;  for  instance,  when  it  is  previously  dried  in  the  open  air  on  some 
compact  body,  as  a  quill  or  a  piece  of  glass,  and  afterwards  secured  in  a  small  vial.* 
But  when  kept  several  days  in  a  state  of  moisture,  and  during  that  time  exposed  to  a 
warm  temperature,  I  do  not  think  it  can  be  relied  upon  as  capable  of  giving  a  perfect 
disease,  although,  as  I  have  before  observed,  the  progress  of  the  symptoms  arising  from 
the  action  of  the  imperfect  matter  bear  so  strong  a  resemblance  to  the  small-pox  when 
excited  completely. 

Thirdly — That  the  first  formed  virus,  or  what  constitutes  the  true  cow-pock  pustule, 
invariably  possesses  the  power  I  have  ascribed  to  it,  namely,  that  of  affecting  the  con¬ 
stitution  with  a  specific  disease,  is  a  truth  that  no  subsequent  occurrence  has  yet  led  me 
to  doubt.  But  as  I  am  now  endeavoring  to  guard  the  public  as  much  as  possible  against 
erroneous  conclusions,  I  shall  observe  that  when  this  pustule  has  degenerated  into  an 
ulcer  (to  which  state  it  is  sometimes  disposed  to  pass,  unless  timely  checked),  I  mispect 
that  matter  possessing  very  different  properties  may  sooner  or  later  be  produced,  and, 
although  it  may  have  passed  that  stage  wherein  the  specific  properties  of  the  matter 
secreted  are  no  longer  present  in  it,  yet,  when  applied  to  a  sore  (as  in  the  casual  way), 
it  might  dispose  that  sore  to  ulcerate,  and  from  its  irritation  the  system  would  pi’ob- 
ably  become  affected;  and  thus,  by  assuming  some  of  its  strongest  characters,  it  would 
imitate  the  genuine  cow-pox 

From  the  preceding  observations  on  the  matter  of  small-pox  when  decomposed,  it  must, 
I  conceive,  be  admitted  that  cow-pox  matter  in  the  state  now  described  may  produce  a 
disease,  the  effects  of  which  may  be  felt  both  locally  and  generally,  yet  that  the  disease 
thus  induced  may  not  be  effectual  in  obviating  the  future  effects  of  variolous  contagion. 
In  the  case  of  Mary  Miller,  related  by  Mr.  Kite  in  the  volume  above  alluded  to,  it  ap¬ 
pears  that  the  inflammation  and  suppuration  of  the  inoculated  arm  were  more  than 
usually  severe,  although  the  system  underwent  no  specific  change  from  the  action  of  the 
virus;  which  appears  from  the  patient’s  sickening  seven  weeks  afterwards  with  the 
natural  small-pox,  which  went  through  its  course.  Some  of  the  cases  communicated  by 
Mr.  Earle  tend  further  to  confirm  this  fact,  as  the  matter  there  manifestly  produced  ul¬ 
ceration  on  the  inoculated  part  to  a  considerable  extent. 

Fourthly. — Whether  the  cow-pox  is  a  spontaneous  disease  in  the  cow,  or  is  to  be  attrib¬ 
uted  to  matter  conveyed  to  the  animal,  as  I  have  conceived,  from  the  horse,  is  a  question 
which,  though  I  shall  not  .attempt  now  fully  to  discuss,  yet  l  shall  digress  so  tar  as  to 
adduce  some  further  observations,  and  to  give  my  reasons  more  at  large  for  taking  up  an 
opinion  that  to  some  has  appeared  fanciful.  The  aggregate  of  these  observations, 

*Thus  prepared  the  cow-pox  virus  was  perfectly  active,  and  possessing  all  its  specific  properties,  at  the 
end  of  three  months. 


36 


Variola  Vaccina :  Edward  Jenner. 


though  not  amounting  to  positive  proof,  forms  presumptive  evidence  of  so  forcible  a 
kind,  that  I  imagine  it  might  on  any  other  person  have  made  the  same  impression  it  did 
on  me,  without  fixing  the  imputation  of  credulity. 

Firstly. — I  conceived  this  was  its  source,  from  observing  that  where  the  cow-pox  had 
appeared  among  the  dairies  here  (unless  it  could  he  traced  to  the  introduction  of  an  in¬ 
fected  cow  or  servant),  it  had  been  preceded  at  the  farm  by  a  horse  diseased  in  the  man¬ 
ner  already  described,  which  horse  had  been  attended,  by  some  of  the  milkers. 

Secondly.  — From  its  being  a  popular  opinion  throughout  this  great  dairy  country,  and 
from  its  being  insisted  on  by  those  who  here  attend  sick  cattle. 

Thirdly. —  From  the  total  absence  of  the  disease  in  those  countries  where  the  men  ser¬ 
vants  are  not  employed  in  the  dairies.* 

Fourthly. — From  having  observed  that  morbid  matter  generated  by  the  horse  fre¬ 
quently  communicates,  in  a  casual  way,  a  disease  to  the  human  subject  so  like  the  cow- 
pox  that  in  many  cases  it  would  he  difficult  to  make  the  distinction  between  one  and  the 
other.! 

Fifthly. — From  being  induced  to  suppose  from  experiments  that  some  of  those  who 
had  been  thus  affected  from  the  horse  resisted  the  small-pox. 

Sixthly. — From  the  progress  and  general  appearance  of  the  pustule  on  the  arm  of  the 
boy  whom  I  inoculated  with  matter  taken  from  the  hand  of  a  a  man  infected  by  a  horse; 
and  from  the  similarity  to  the  cow-pox  of  the  general  constitutional  symptoms  which 
followed.! 

I  fear  it  would  be  trespassing  too  far  to  adduce  the  general  testimony  of  our  farmers 
in  support  of  this  opinion;  yet  I  beg  leave  to  introduce  an  extract  from  a  letter  on  this 
subject  from  the  Rev  Mr.  Moore,  of  Chalford  Hill,  in  this  county  : 

“In  the  month  of  November,  1797.  my  horse  had  diseased  heels,  which  was  certainly 
what  is  termed  the  grease;  and  at  a  short  subsequent  period  my  cow  was  also  affected 
with  what  a  neighboring  farmer  (who  was  conversant  with  the  complaints  of  cattle), 
pronounced  to  be  the  cow-pox,  which  he,  at  the  same  time,  observed  my  servant  would 
be  infected  with;  and  this  proved  to  be  the  case,  for  ho  had  eruptions  on  his  hands,  face 
and  many  parts  of  the  body,  the  pustules  appearing  large,  and  not  much  unlike  the. 
small-pox,  for  which  he  had  been  inoculated  a  year  and  a  half  before,  and  had  then  a 
very  heavy  burthen.  The  pustules  on  the  face  might  arise  from  contact  with  his  hands, 
as  he  had  a  habit  of  rubbing  his  forehead,  where  the  sores  were  the  largest  and  thickest. 

“The  boy  associated  with  the  farmer’s  sons  during  the  continuance  of  the  disease, 
neither  of  whom  had  had  the  small-pox,  but  they  felt  no  ill  effects  whatever.  He  was 
not  much  indisposed,  as  the  disease  did  not  prevent  him  from  following  his  occupations 
as  usual.  No  other  person  attended  the  horse  or  milked  the  cow  hut  the  lad  above  men¬ 
tioned.  I  am  firmly  of  opinion  that  the  disease  in  the  heels  of  the  horse,  which  was  a 
virulent  grease,  was  the  origin  of  the  servant’s  and  the  cow’s  malady.” 

But  to  return  to  the  more  immediate  object  of  this  proposition: 

From  the  similarity  of  symptoms,  both  constitutional  and  local,  between  the  cow-pox 
and  the  disease  received  from  morbid  matter  generated  by  a  horse,  the  common  people 
in  this  neighborhood,  when  infected  with  this  disease,  through  a  strange  perversion  of 
terms,  frequently  called  the  cow-pox.  Let  us  suppose,  then,  such  a  malady  to  appear 
among  some  of  the  servants  at  the  farm,  and  at  the  same  time  that  the  cow-pox  were  to 
break  out  among  the  cattle;  and  let  us  suppose,  too,  that  some  of  the  servants  were  in¬ 
fected  in  this  way,  and  that  others  received  the  infection  from  the  cows.  It  would  be 
recorded  at  the  farm,  and  among  the  servants  themselves,  wherever  they  might  after¬ 
wards  be  dispersed,  that  they  had  all  had  the  cow-pox.  But  it  is  clear  that  an  individ¬ 
ual  thus  infected  from  the  horse,  would  neither  be  for  a  certainty  ’secure  himself,  nor 
would  he  impart  security  to  others  were  they  inoculated  by  virus  thus  generated.  He 
still  would  be  in  danger  of  taking  the  small-pox.  Yet  were  this  to  happen  before  the 
nature  of  the  cow-pox  be  more  maturely  considered  by  the  public,  my  evidence  on  the 
subject  might  be  depreciated  unjustly.  For  an  exemplification  of  what  is  here  advanced 
relative  to  the  nature  of  the  infection  when  received  directly  from  the  norse,  see  “In¬ 
quiry  into  the  Causes  and  Effects  of  the  Variola}  Vaccin.se,”  pages  25,  26,  27,  28  and  page 
33;  and  by  way  of  further  example,  I  beg  leave  to  subjoin  the  following  intelligence 
received  from  Mr.  Fewster,  surgeon,  of  Thornbury,  in  this  county,  a  gentleman  per¬ 
fectly  well  acquainted  with  the  appearances  of  the  cow-pox  on  the  human  subject. 

‘This  information  was  communicated  to  mo  from  the  first  authorities. 

tThe  sound  shin  does  not  appear  to  he  susceptible  of  this  virus  when  inserted  into  it,  bur  when  pre¬ 
viously  diseased  from  little  accidents  its  effects  are  often  conspicuous .  See  plate  N o.  2.  ‘ 

jThis  case  (on  which  I  laid  no  inconsiderable  stress  in  my  late  treatise,  as  presumptive  evidence  of  the 
fact  adduced)  seems  to  have  been  either  mistaken  or  overlooked  by  those  who  have  commented  upon  the 
subject, — See  case  XVIII,  page  33.  The  boy  unfortunately  died  of  a  fever  at  a  parish  work  house  helot  e  I 
had  an  opportunity  of  observing  what  effects  would  have  been  produced  by  the  matter  of  small-pox.  'i  lie 
experiments  published  by  Mr.  Simmons,  of  Manchester,  and  others,  on  the  subject,  with  the  view  of  relat¬ 
ing  this  theory,  appear  to  have  but  little  weight,  as  even  the  cow-pox  virus  itself,  when  repeatedly  intro • 
dneed  into  the  sound  nipples  of  cows  by  means  of  a  lancet,  was  found  to  produce  no  effect. 


Variola;  Vaccince :  Edward  Jenner. 


37 


William  Morris,  aged  thirty-two,  servant  to  Mr.  Cox,  of  Almonshury,  in  this  comity, 
applied  to  me  on  the  second  of  April,  1798.  He  told  me  that  four  days  before  he  found  a 
stiffness  and  swelling  in  botji  hands,  which  were  so  painful  it  was  with  difficulty  he 
continued  his  work;  that  he  had  been  seized  with  pain  in  his  head,  small  of  the  back, 
and  limbs,  and  with  frequent  chilly  fits  si  cceeded  by  fever.  On  examination  I  found 
him  still  affected  with  these  symptoms,  and  that  there  was  a  great  prostration  of 
strength.  Many  parts  of  his  hands  on  the  inside  were  chapped,  and  on  the  middle  joint 
of  the  thumb  of  the  right  hand  there  was  a  small  phagedenic  ulcer,  about  the  size  of  a 
large  pea,  discharging  an  ichorous  fluid.  On  the  middle  finger  of  the  same  hand  there 
was  another  ulcer  of  a  similar  kind.  These  sores  were  of  a  circular  form,  and  he  de¬ 
scribed  tlioir  first  appearance  as  being  somewhat  like  blisters  arising  from  a  burn.  He 
complained  of  excessive  pain,  which  extended  up  his  arm  into  the  axilla.  These  symp¬ 
toms  and  appearances  of  the  sores  were  so  exactly  like  the  cow-pox,  that  I  pronounced 
he  had  taken  the  distemper  from  milking  cows.  He  assured  me  he  had  not  milked  a  cow 
for  more  than  half  a  year,  and  that  his  master’s  cows  had  nothing  the  matter  with  them. 
I  then  asked  him  if  his  master  had  a  greasy  horse?  which  he  answered  in  the  affirma¬ 
tive,  and  further  said  that  he  had  constantly  dressed  him  twice  a  day  for  the  last  three 
weeks  or  more,  and  remarked  that  the  smell  of  his  hands  was  much  like  that  of  the 
horse’s  heels.  On  the  fifth  of  April  1  again  saw  him,  and  touud  him  still  complaining  of 
pain  in  both  his  hands,  nor  were  his  febrile  symptoms  at  all  relieved.  The  ulcers  had 
now  spread  to  the  size  of  a  seven  shilling  gold  coin,  and  another  ulcer,  which  I  had  not 
noticed  before,  appeared  on  the  first  joint  of  the  forefinger  of  the  left  hand,  equally  pain¬ 
ful  with  that  on  the  right.  I  ordered  him  to  bathe  his  hands  in  warm  bran  and  water, 
applied  escharotics  to  the  ulcers,  and  wrapped  his  hands  up  in  a  sofl  cataplasm.  The 
next  day  he  was  much  relieved,  and  in  something  more  than  a  fortnight  got  well.  He 
lost  his  nails  from  the  thumb  and  fingers  that  were  ulcerated.” 

The  sudden  disappearance  of  the  symptoms  in  this  case,  after  the  application  of  the 
escharotics  to  the  sores,  is  worthy  of  observation.  It  seems  to  show  that  they  were 
kept  up  by  the  irritation  of  the  ulcers. 

Che  general  symptoms  which  I  have  already  described  of  the  cow-pox,  when  commu¬ 
nicated  in  a  casual  way  to  any  great  extent,  will,  I  am  convinced,  from  the  many  cases 
I  have  seen,  be  found  accurate;  but  from  the  very  slight  indisposition  which  ensues  in 
cases  of  inoculation,  where  the  pustule,  after  afl'ectiug  the  constitution,  quickly  runs 
into  a  scab  spon  taneously,  or  is  artificially  suppressed  by  some  proper  application,  I  am 
induced  to  believe  that  the  violence  of  the  spmptoms  may  be  ascribed  to  the  inflamma¬ 
tion  and  irritation  of  the  ulcers  (when  ulceration  takes  place  to  any  extent,  as  in  the 
casual  small-pox),  and  that  the  constitutional  symptoms  which  appear  during  the 
presence  of  the  sore,  while  it  assumes  the  character  of  a  pustule  on  y,  are  felt  but  in  a 
very  trifling  degree.  This  mild  affection  of  the  system  happens  when  the  disease  makes 
but  a  slight  local  impression  on  those  who  have  been  accidentally  infected  by  cows  ; 
and,  as  far  as  I  have  seen,  u  has  uniformly  happened  among  those  who  have  been  inocu¬ 
lated,  when  a  pustule  only,  and  no  great  degree  of  inflammation  or  any  ulceration,  has 
taken  place  from  the  inoculation.  The  following  cases  will  strengthen  this  opinion  : 

The  cow-pox  appeared  at  a  farm  in  the  village  of  Stouehouse,  in  this  county,  about 
Michaelmas  last,  and  continued  gradually  to  pass  from  one  cow  to  another  till  the  end 
of  November.  On  the  twenty-sixth  of  that  month  some  ichorous  matter  was  taken  from 
a  cow,  oud  dried  upon  a  quill.  On  the  second  of  December  some  of  it  was  inserted  into 
a  scratch,  made  so  superficial  that  no  blood  appeared,  on  the  arm  of  Susan  Phipps,  a 
child  seven  years  old.  The  common  inflammatory  appearances  took  place  in  conse¬ 
quence,  and  advanced  till  the  fifth  day,  when  they  had  so  much  subsided  that  I  did  not 
conceive  anything  further  would  ensue. 

Sixth. — Appearances  stationary. 

Seventh. — The  inflammation  began  to  advance. 

Eighth. — A  vesication  perceptible  on  the  edges,  forming,  as  in  the  inoculated  small¬ 
pox,  an  appearance  not  unlike  a  grain  of  wheat,  with  the  cleft  or  indention  in  the  centre. 

Ninth. — Pain  in  the  axilla. 

Tenth. — A  little  headache;  puise  110;  tongue  not  discolored;  countenance  in  health. 

Eleventh. — No  perceptible  illness;  pulse  about  100. 

Thirteenth. — The  pustule  was  now  surrounded  by  an  efflorescence,  interspersed  •with 
very  minute  confluent  pustules,  to  the  extent  of  about  an  inch.  Some  of  these  pustules 
advanced  in  size  and  maturated.  So  exact  was  the  lesemblanee  of  the  arm  at  this  stage 
to  the  general  appearance  of  the  inoculated  small-pox,  that  Mr.  D.,  a  neighboring  sur¬ 
geon,  who  took  some  matter  from  it,  and  who  had  never  seen  the  cow-pox  before,  de¬ 
clared  he  could  not  perceive  any  difference.*  The  child’s  arm  now  showed  a  disposition 

*That  the  cow-pox  was  the  supposed  guardian  of  the  constitution  from  tins  action  of  the  sin  all-pox  has 
been  a  prevalent  idea  for  a  long  time  past,  but  the  similarity  in  the  constitutional  effects  bet  ween  one  dis¬ 
ease  and  the  other  could  never  have  been  so  accurately  observed  had  not  the  inoculation  of  the  cow-pox 
placed  it  in  a  new  and  stronger  point  of  view .  This  practice,  too,  has  shown  us  what  before  lay  concealed, 
the  rise  and  progress  of  the  pustule  formed  by  the  insertion  of  the  virus,  which  places  in  a  most  conspicu¬ 
ous  light  its  striking  resemblance  to  the  pustule  from  the  iuoculated  small-pox. 


38 


Variolce  Vaccince  :  Edward  Jenner. 


to  scab,  and  remained  stationary  for  two  or  three  days,  when  it  began  to  run  into  an 
ulcerous  state;  and  then  commenced  a  febrile  disposition,  accompanied  with  an  increase 
of  axillary  tumor.  The  nicer  continued  spreading  near  a  week,  during  which  time  the 
child  continued  ill,  when  it  increased  to  a  size  nearly  as  large  as  a  shilling.  It  began 
now  to  discharge  pus  ;  granulations  sprung  up,  and  it  healed.  This  child  had  before 
been  of  a  remarkably  sickly  constitution,  but  is  now  in  very  high  health. 

Mary  Hearn,  twelve  years  of  age,  was  inoculated  with  matter  taken  from  the  arm  of 
Susan  Phipps. 

Sixth  day. — A  pustule  beginning  to  appear,  slight  pain  in  the  axilla. 

Seventh. — A  distinct  vesicie  formed. 

Eighth. — The  vesicle  increasing;  edges  very  red;  no  deviation  at  this  time  from  the 
inoculated  small-pox. 

Ninth. — No  indisposition  ;  pustule  advancing. 

Tenth. — The  patient  felt  this  evening  a  slight  febrile  attack. 

Eleventh.— Free  from  indisposition. 

Twelfth— Thirteenth. — The  same. 

Fourteenth. — An  efflorescence  of  a  faint  red  color,  extending  several  inches  around  the 
arm.  The  pustule  beginning  to  show  a  disposition  to  spread,  was  dressed  with  an  oint¬ 
ment  composed  of  hydrarg.  nit.  rub.  f  ung  cerce.  The  efflorescence  itself  was  covered 
with  a  plaster  of  ung  bydr.  fort ,  In  six  hours  it  was  examined,  w'lien  it  was  found  that 
the  efflorescence  had  totally  disappeared.  The  application  of  the  ointment  with  the 
by  dr.  nit.  rub.  was  made  use  of  for  three  days,  when  the  state  of  the  pustule  remaining 
stationary,  it  Was  exchanged  for  the  ung.  liydr.  nit.  This  appeared  to  have  a  more  active 
effect  than  the  former,  and  in  two  or  three  hours  the  virus  seemed  to  be  subdued,  when 
a  simple  dressing  was  made  use  of;  but  the  sore  again  showing  a  disposition  to  inflame, 
the  ung.  bydr.  nit.  was  again  applied,  and  soon  answered  the  intended  purpose  effect¬ 
ually.  The  girl,  after  the  tenth  day,  when,  as  has  been  observed,  she  became  a  little  ill, 
showed  not  the  least  symptom  of  indisposition.  She  was  afterwards  exposed  to  the 
action  of  variolous  matter,  and  completely  resisted  it.  Susan  Phipps  also  went  through 
a  similar  trial. 

Conceiving  these  cases  to  be  important,  I  have  given  them  in  detail ;  first,  to  urge  the 
precaution  of  using  such  means  as  may  stop  the  progress  of  the  pustule  ;  and  secondly, 
to  point  out,  what  appears  to  be  the  fact,  that  the  most  material  indisposition,  or  at 
least  that  which  is  felt  most  sensibly,  does  mot  arise  primarily  from  the  first  action  of  the 
virus  on  the  constitution ,  but  that  it  often  comes  on,  if  the  pustule  is  left  to  chance,  as  a  secondary 
disease.  This  leads  me  to  conjecture,  what  experiment  must  finally  determine,  that 
they  who  have  had  the  small-pox  are  not  afterwards  susceptible  of  the  primary  action 
of  the  cow-poxvirus;  for,  seeing  that  the  simple  virus  itself,  when  it  has  not*  passed 
beyond  the  boundary  of  a  vesicle,  excites  in  the  system  so  little  commotion,  is  it  not 
probable  the  trifling  illness  thus  induced  may  be  lost  in  that  which  so  quickly,  and  often 
times  so  severely,  follows  in  the  casual  cow-pox  from  the  presence  of  corroding  ulcers  ? 
This  consideration  induces  me  to  suppose  that  I  may  have  been  mistaken  in  my  former 
observation  on  this  subject. 

In  this  respect,  as  well  as  many  others,  a  parallel  may  be  drawn  between  this  disease 
and  the  small-pox.  In  the  latter,  the  patient  first  feels  the  effect  of  what  is  called  the 
absorption  of  the  virus.  The  symptoms  then  often  nearly  retire,  when  a  fresh  attack 
commences,  different  from  the  first,  and  the  illness  keeps  pace  with  the  progress  of  the 
pustules  through  their  different  stages  of  maturation,  ulceration,  etc. 

Although  the  application  I  have  mentioned  iu  the  case  of  Mary  Hearn  proved  sufficient 
to  check  the  progress  of  ulceration,  and  prevent  any  secondary  symptoms,  yet,  after  the 
pustule  has  duly  exerted  its  influence,  I  should  prefer  the  destroying  it  quickly  and 
effectually  to  any  other  mode.  The  term  caustic  to  a  tender  ear  (and  I  conceive  none 
will  feel  more  interested  in  this  inquiry  than  the  anxious  guardians  of  a  nursery),  may 
sound  harsh  and  unpleasing,  but  every  solicitude  that  may  arise  on  this  account  will  no 
longer  exist,  when  it  is  understood  that  the  pustule  in  a  state  fit  to  be  acted  upon  is 
then  quite  superficial,  and  that  it  does  not  occupy  the  space  of  a  silver  penny.* 

As  a  proof  of  the  efficacy  of  this  practice,  even  before  the  virus  had  fully  exerted 
itself  on  the  system,  I  shall  lay  before  my  reader  the  following  history  : 

By  a  reference  to  the  treatise  on  the  Variolae  Vaccinae,  it  will  be  seen  that  in  the 
month  of  April,  1798,  four  children  were  inoculated  with  the  matter  of  cow-pox;  and 
that  in  two  of  these  cases  the  virus  on  the  arm  was  destroyed  soon  after  it  had  produced 
a  perceptible  sickening. 

Mary  James,  aged  seven  years,  one  of  the  children  alluded  to,  was  inoculated  in  the 
month  of  December  following  with  fresh  variolous  matter,  and  at  the  same  time  was 
exposed  to  the  effluvia  of  a  patient  affected  with  the  small-pox.  The  appearance  and 

*1  mention  escharotics  for  stopping  the  progress  of  the  pustule,  because  I  am  acquainted  with  their 
efficacy.  Probably  more  simple  means  might  answer  the  purpose  quite  as  well,  such  as  might  be  found 
among  the  mineral  and  vegetable  astringents.  * 


Variolai  Vaccina! :  Edward  Jenner. 


39 


progress  of  the  infected  arm  was,  in  every  respect,  similar  to  that  which  we  generally 
observe  when  variolous  matter  has  been  inserted  into  the  skin  of  a  person  who  has  not 
previously  undergone  either  the  cow-pox  or  the  small-pox.  On  the  eighth  day,  conceiv¬ 
ing  there  was  infection  in  it,  she  was  removed  from  her  residence  among  those  who  had 
not  had  the  small-pox.  I  was  now  anxiously  waiting  the  result  .conceiving  from  the 
state  of  the  girl’s  arm  she  would  fall  sick  about  this  time.  On  visiting  her  on  the  even¬ 
ing  of  the  following  day  (the  ninth),  all  I  could  learn  from  the  woman  who  attended 
her  was  that  .she  felt  somewhat  hotter  than  usual  during  the  night,  but  was  not  restless, 
and  that  in  the  morning  there  was  the  faint  appearance  of  a  rash  around  her  wrists. 
This  went  off  in  a  few  hours,  and  was  not  at  all  perceptible  to  me  on  my  visit  in  the 
evening.  Not  a  single  eruption  appeared,  the  skin  having  been  repeatedly  and 
carefully  examined.  The  inoculated  arm  continued  to  make  the  usual  progress  to  the 
end,  through  all  the  stages  of  inflammation,  maturation  and  scabbing. 

On  the  eighth  day  matter  was  taken  from  the  arm  of  this  girl  (Mary  Janies),  and  in¬ 
serted  into  the  arms  of  her  mother  and  brother,  (neither  of  whom  had  had  either  the 
small-pox  or  the  cow-pox),  the  former  about  fifty  years  of  ago,  the  latter  six. 

On  the  eighth  day  after  the  insertion,  the  boy  felt  indisposed,  and  continued  unwell 
two  days,  when  a  measles-like  rash  appeared  on  his  hands  and  wrists,  and  was  thinly 
scattered  over  his  arms.  The  day  following  his  body  was  marbled  over  with  an  appear¬ 
ance  somewhat  similar,  but  he  did  not  complain,  nor  did  he  appear  indisposed.  A  few 
pustules  now  appeared,  the  greater  part  of  which  went  away  without  maturating. 

On  the  ninth  day  the  mother  began  to  complain.  She  was  a  little  chilly,  and  had  a 
head-ache  for  two  days,  but  no  pustule  appeared  on  the  skin,  nor  had  she  any  appearance 
of  a  rash . 

The  family  was  attended  by  an  elderly  woman  as  a  nurse,  who,  in  her  infancy  had 
been  exposed  to  the  contagion  of  the  small-pox,  but  had  resisted  it.  This  woman  was 
now  infected,  but  had  the  disease  in  t lie  slightest  manner,  a  very  few  eruptions  appear¬ 
ing,  two  or  three  of  which  only  maturated. 

From  a  solitary  instance  like  that  adduced  of  Mary  James,  whose  constitution  appears 
to  have  resisted  the  action  of  the  variolous  virus,  after  the  influence  of  the  cow-poxvirus 
had  been  so  soon  arrested  in  its  progress,  no  positive  conclusion  can  be  fairly  drawn  ; 
nor  from  the  history  of  the  three  other  patients,  who  were  subsequently  infected  ;  but, 
nevertheless,  the  facts  collectively  may  be  deemed  interesting. 

That  one  mild  variety  of  the  small-pox  has  appeared,  I  have  already  plainly  shown  ; 
and  by  the  means  now  mentioned  we  probably  may  have  it  in  our  pawer  to  produce  at 
will  another. 

At  the  time  when  the  pustule  was  destroyed  in  the  arm  of  Mary  James,  I  was  informed 
she  had  been  indisposed  about  twelve  hours  :  but  I  am  now  assured  by  those  who  were 
with  her  that  the  space  of  time  was  much  less.  Be  that  as  it  may,  in  cases  of  cow-pox 
inoculation  I  would  m  t  recommend  any  application  to  subdue  the  action  of  the  pustule, 
until  convincing  proofs  had  appeared  of  the  patient’s  having  felt  its  effects  at  least 
twelve  hours  No  harm,  indeed,  could  ensue,  were  a  longer  period  to  elapse  before  the 
application  was  made  use  of.  In  short,  it  should  be  suffered  to  have  as  full  effect  as  it 
could,  consistently  with  the  state  of  the  arm. 

As  the  cases  of  inoculation  multiply,  I  am  more  and  more  convinced  of  the  extreme 
mildness  of  the  symptoms  arising  merely  from  the  primary  action  of  the  virus  on  the 
constitution,  and  that  those  symptoms  which  (as  in  the  accidental  cow-pox),  affect  the 
p  itieut  with  severity,  are  entirely  secondary,  excited  by  the  irritating  processes  of  in¬ 
flammation  and  ulceration  ;  and  it  appears  to  me  that  this  singular  virus  possesses  an 
irritating  quality  of  a  peculiar  kind ;  but  as  a  single  cow-pox  pustule  is  all  that  is  neces¬ 
sary  to  render  the  variolous  virus  ineffectual,  and  as  we  possess  the  means  of  allaying 
the  irritation,  should  any  arise,  it  becomes  of  little  or  no  consequence. 

It  a  ppears,  then,  (as  far  as  inference  can  be  drawn  from  the  present  progress  of  cow-pox 
inoculation),  that  it  is  an  accidental  circumstance  only,  which  can  render  this  a  violent 
disease,  and  a  circumstance  of  that  nature  which,  fortunately,  it  is  in  the  power  of 
almost  every  one  to  avoid.  I  allude  to  the  communication  of  the  disease  from  cows.  In 
this  case,  should  the  hands  of  the  milker  be  affected  with  little  accidental  sores  to  any 
extent,  every  sore  would  become  the  nidus  of  infection,  and  feel  the  influence  of  the 
virus;  and  the  degree  of  violence  in  the  constitutional  symptoms  would  be  in  proportion 
to  the  number  and  to  the  state  of  these  local  affections.  Hence  it  follows  that  a  person, 
either  by  accident  or  design,  might  be  so  filled  with  these  wounds  from  contact  with  the 
virus,  that  the  constitution  might  sink  u  ider  the  pressure. 

Seeing  that  we  possess  the  means  of  rendering  the  action  of  the  sores  mild,  which, 
when  left  to  chance,  are  capable  of  producing  violent  effects  ;  and  seeing,  too,  that  these 
sores  bear  a  resemblance  to  the  small-pox,  especially  the  confluent,  should  it  not  encour¬ 
age  the  hope  that  some  topical  application  might  be  used  with  advantage  to  counteract 
the  fatal  tendency  of  that  disease,  when  it  appears  in  this  terrific  form?  At  what  stage 


40 


Variola;  Vaccince :  Edward  Jenner. 


or  stages  of  tlie  disease  this  may  be  done  with  the  most  promising  expectation  of  suc¬ 
cess,  I  will  not  pretend  now  to  determine.  I  only  throw  out  this  idea  as  the  basis  of 
further  reasoning  and  experiment 

I  have  often  been  foiled  in  my  efforts  to  communicate  the  cow-pox  by  inoculation.  An 
inflammation  will  sometimes  succeed  the  scratch  or  puncture,  and  in  a  few  days  disap¬ 
pear  without  producing  any  further  effect.  Sometimes  it  will  even  produce  an  ichorous 
fluid,  and  yet  the  system  will  not  be  affected. *  The  same  thing,  we  know,  hajqmns  with 
the  small-pox  virus- 

Four  or  five  servants  were  inoculated  at  a  farm  contiguous  to  this  place,  last  summer, 
with  matter  just  taken  from  an  infected  cow.  A  little  inflammation  appeared  on  all 
their  arms,  but  died  away  without  producing  a  pustule  ;  yet  all  these  servants  caught 
the  disease  within  a  month  afterwards  from  milking  the  infected  cows,  and  some  of  them 
had  it  severely.  At  present,  no  other  mode  than  that  commonly  practiced  for  inoculat¬ 
ing  the  small-pox  has  been  used  for  giving  the  cow-pox  ;  but  it  is  probable  this  might 
be  varied  with  advantage.  We  should  imitate  the  casual  communication  more  clearly, 
were  we  first,  by  making  the  smallest  superficial  incision  or  puncture  on  the  skin,  to 
produce  a  little  scab,  and  then,  removing  it,  to  touch  the  abraded  pare  with  the  virus. 
A  small  portion  of  a  thread  imbrued  in  the  virus  (as  in  the  old  method  of  inoculating 
the  small-pox),  and  laid  upon  the  slightly  incised  skin,  might  probably  prove  a  success¬ 
ful  way  of  giving  the  disease;  or  the  cutis  might  be  exposed  in  a  minute  point  by  an 
atom  of  blistering  plaster,  and  the  virus  brought  in  contact  with  it.  In  the  cases  just 
alluded  to,  where  I  did  not  succeed  in  giving  the  disease  constitutionally,  the  experi¬ 
ment.  was  made  with  matter  taken  in  a  purulent  state  from  a  pustule  on  the  nipple  of  a 
cow.t 

Is  pure  pus,  though  contained  in  a  small-pox  pustule,  ever  capable  of  producing  the 
small-pox  perfectly?  I  suspect  it  is  not.  Let  us  consider  that  it  is  always  preceded  by 
the  limpid  fluid,  which,  in  constitutions  susceptible  of  variolous  contagion,  is  always 
infectious  ;  and  though,  on  opening  a  pustule,  its  contents  may  appear  perfectly  puru¬ 
lent,  yet  a  given  quantity  of  the  limpid  fluid  may  at  the  same  time  be  blended  with  it, 
though  it  would  be  imperceptible  to  the  only  test  of  our  senses,  the  eye.  The  presence, 
then,  of  tiffs  fluid,  or  its  mechanical  diffusion  through  pus,  may  at  all  times  render  active 
what  is  apparently  mere  pus,  while  its  total  absence  (as  in  stale  pustules)  may  be 
attended  with  the  imperfect  effects  we  have  seen. 

It  would  be  digressing  too  widely  to  go  far  into  the  doctrine  of  secretion,  but  as  it 
will  not  be  quite  extraneous,  I  shall  just  observe  that  I  consider  both  the  pus  and  the 
limpid  fluid  of  the  pustule  as  secretions,  but  that  the  organs  established  by  nature  to 
perform  the  office  of  secreting  these  fluids  may  differ  essentially  in  their  mechanical 
structure.  What  but  a  difference  in  the  organization  of  glandular  bodies  constitutes  the 
difference  in  the  qualities  of  the  fluids  secreted  ?  From  some  peculiar  derangement  in 
the  structure,  or,  in  other  words,  some  deviation  in  the  natural  action  of  a  gland  destined 
to  secrete  a  mild,  innoxious  fluid,  a  poison  of  the  most  deadly  nature  may  be  created. 
For  example:  That  gland,  which  in  its  sound'  state,  secretes  pure  saliva,  may,  from  be¬ 
ing  thrown  into  diseased  action,  produce  a  poison  of  the  most  destructive  quality. 
Nature  appears  to  have  no  more  difficulty  in  forming  minute  glands  among  the  vascular 
parts  of  the  body,  than  she  has  in  forming  blood  vessels,  and  millions  of  these  can  be 
called  into  existence,  when  inflammation  is  excited,  in  a  few  hours.! 

In  the  present  early  stage  of  the  inquiry,  (for  early  it  certainly  must  be  deemed),  be¬ 
fore  we  know  for  an  absolute  certainty  how  soon  the  virus  of  the  cow-pox  may  suffer  a 
change  in  its  specific  properties,  after  it  has  quitted  the  limpid  state  it  possessed  when 
forming  a  pustule,  it  would  he  prudent  for  those  who  have  been  inoculated  with  it  to 
submit  to  variolous  inoculation.  No  injury  or  inconvenience  can  accrue  from  this,  and 
were  the  same  method  practiced  among  those,  who,  from  inoculation,  have  felt  the 
small-pox  in  an  unsatisfactory  manner  at  any  period  of  their  lives,  it  might  appear  that 
I  had  not  been  too  officious  in  offering  a  cautionary  hint,  in  recommending  a  second  in¬ 
oculation  with  matter  in  its  most  perfect  state. 

And  here  let  me  suppose,  for  argument’s  sake,  (not  from  conviction),  that  one  person 
in  an  hundred,  after  having  had  the  cow-pox  should  be  found  susceptible  of  the  small¬ 
pox,  would  this  invalidate  the  utility  of  the  practice  ?  For,  waving  all  other  considera¬ 
tions,  who  will  deny  that  the  inoculated  small-pox,  though  abstractedly  it  may  be  con¬ 
sidered  as  harmless,  does  not  involve  in  itself  something  that  in  numberless  instances 
proves  baneful  to  the  human  frame. 

That  in  delicate  constitutions  it  sometimes  excites  scrofula  is  a  fact  that  must  be  gen¬ 
erally  subscribed  to,  as  it  is  so  obvious  to  common  observation.  This  consideration  is 
important. 

*At  this  period  of  the  inquiry  I  had  not  discovered  the  importance  of  inoculating  with  virus  newly 
formed  in  the  pustule.  The  reader  will  find  this  explained  as  he  proceeds. 

tThe  cause  of  these  disappointments  will  he  explained. 

|Mr.  Home,  in  his  excellent  dissertation  on  pus  and  mucus,  justifies  this  assertion. 


Variolce  Vaccincv  :  E dicard  Jenner. 


41 


As  the  effects  of  the  small-pox  inoculation  ou  those  -who  have  had  the  cow-pox,  will  he 
watched  with  the  most  scrupulous  eye  by  those  who  prosecute  this  inquiry,  it  may  he 
proper  to  bring  to  their  recollection  some  facts  relative  to  the  small-pox,  which  1  must 
consider  here  as  of  consequence,  but  which  hitherto  seem  not  to  have  made  a  due  im¬ 
pression. 

It  should  be  remembered  that  the  constitution  cannot  by  previous  infection  be  ren¬ 
dered  totally  unsusceptible  of  the  variolous  poison  ;  neither  the  casual  nor  the  inoculated 
small-pox,  whether  it  produces  the  disease  in  a  mild  or  in  a  violent  way,  can  perfectly 
extinguish  the  susceptibility.  The  skin,  we  know,  is  ever  ready  to  exhibit,  though  often 
in  a  very  limited  degree,  the  effects  of  the  poison  when  inserted  there;  and  how  fre¬ 
quently  do  we  see  among  nurses,  when  much  exposed  to  the  contagion,  eruptions,  and  these 
sometimes  preceded  by  sensible  illness!  Yet,  should  anything  like  an  eruption  appear, 
or  the  smallest  degree  of  indisposition,  upon  the  insertion  of  the  variolous  matter  on 
those  who  have  gone  through  the  cow-pox,  my  assertions  respecting  the  peculiarities 
of  the  disease  might  be  unjustly  discredited. 

I  know  a  gentleman  who,  many  years  ago,  was  inoculated  for  the  small-pox,  but  hav¬ 
ing  no  pustules  or  scarcely  any  constitutional  affection  that  was  perceptible  he  was  dis¬ 
satisfied,  and  has  siace  been  repeatedly  inoculated.  A  vesicle  has  always  been  produced 
in  the  arm  in  consequence,  with  axillary  swelling  and  a  slight  indisposition.  This  is  by 
no  means  a  rare  occurrence.  It  is  probable  that  the  fluid  thus  excited  upon  the  skin 
would  always  produce  the  small-pox. 

On  the  arm  of  a  person  who  had  gone  through  the  cow-pox  many  years  before,  I  once 
produced  a  vesication  by  the  infection  of  variolous  matter,  and  with  a  little  of  the 
fluid  inoculated  a  young  woman,  who  had  a  mild,  but  very  efficacious,  small-pox  in  con¬ 
sequence,  although  no  constitutional  effect  was  produced  on  the  patient  from  whom  the 
matter  was  taken. 

The  following  communication  from  Mr.  Fewster  affords  a  still  clearer  elucidation  of 
this  fact.  Mr.  Fewster  says: 

“On  the  third  of  April,  1797,  1  inoculated  Master  H - ,  aged  fourteen  mouths,  for 

the  sma  1-pox.  At  the  usual  time  he  sickened,  had  a  plentiful  eruption,  particularly  on 
his  face,  and  got  well.  His  nursemaid,  aged  twenty-four,  had  many  years  before  gone 
through  the  small-pox  in  the  natural  way,  which  was  evident  from  her  being  much  pitted 
with  it.  She  had  used  the  child  to  sleep  on  her  left  arm,  with  her  left  cheek  in  contact 
with  his  face,  and  during  his  inoculation  had  mostly  slept  in  that  manner  About  a 
week  after  the  child  got  wrell  she  (the  nurse)  desired  me  to  look  at  her  face,  which  she 
said. was  very  painful.  There  was  a  plentiful  eruption  on  the  left  cheek,  but  not  on  any 
other  part  of  the  body,  which  went  on  to  maturation. 

“On  inquiry,  I  found  that  three  days  before  the  appearance  of  the  eruption  she  was 
taken  with  slight  chilly  fits,  pain  in  her  head  and  limbs,  and  some  fever.  On  the  appear¬ 
ance  of  the  eruption  these  pains  went  off,  and  now  (the  second  day  of  fhe  eruption)  she 
complains  of  a  little  sore  throat.  Whether  the  above  symptoms  are  the  effects  of  the 
small-pox  or  a  recent  cold,  I  do  not  know.  On  the  fifth  day  of  the  eruption,  I  charged  a 
lancet  from  two  of  the  pustu  es,  and  on  the  next  day  I  inoculated  two  children — one  two 
years,  and  the  other  four  months  old  with  the  matter.  At  the  same  time  I  inoculated 

the  mother  and  eldest  sister  with  variolous  matter  taken  from  Master  H - .  On  the 

fifth  day  of  their  inoculation  all  their  arms  were  inflam'd  alike;  and,  on  the  eighth  day, 
the  eldest  of  those  inoculated  from  the  nurse  sickened,  and  the  youngest  on  the  eleventh. 
They  had  both  a  plentiful  eruption,  from  which  I  inoculated  several  others,  who  had  the 
disease  very  favorably.  The  mother  and  the  other  child  sickened  about  the  same  time, 
and  likewise  had  a  plentiful  eruption. 

“  Soon  after  a  man  in  the  village  sickened  with  the  small-pox,  and  had  a  confluent 
kind.  To  be  convinced  that  the  children  had  had  the  disease  effectually,  I  took  them  to 
his  house,  and  inoculated  them  in  both  arms  with  matter  taken  from  him,  but  without 
effect.” 

These  are  not  brought  forward  as  uncommon  occurrences,  but  as  exemplifications  of 
the  human  system’s  susceptibility  of  the  variolous  contagio^I  although  it  has  been  pre¬ 
viously  sensible  of  its  action. 

Happy  it  is  for  mankind  that  the  appearance  of  the  small-pox  a  second  time  on  the 
same  person  beyond  a  trivial  extent,  is  so  extremely  rare  that  it  is  looked  upon  as  a  phe¬ 
nomenon.  Indeed,  since  the  publication  of  Dr.  Heberden’s  paper  on  the  Varicelhe,  or 
chicken-pox,  the  idea  of  such  an  occurrence,  in  deference  to  authority  so  truly  respectable, 
has  been  generally  relinquished  This,  I  conceive,  has  been  without  just  reason  ;  for, 
after  we  have  seen,  among  many  others,  so  strong  a  case  as  that  recorded  by  Mr.  Edward 
Withers,  surgeon,  of  Newbury,  Berks,  in  the  fourth  volume  of  the  memoirs  of  the  Medi¬ 
cal  Society  of  London  (from  which  I  take  the  following  extracts),  no  one,  I  think,  will 
again  doubt  the  fact: 


42 


Variolce  Vaccines  :  Edward  Jenner. 


“Mr.  Richard  Langford,  a  farmer  of  West  Shefford,  in  this  county  (Berks),  about  fifty 
years  of  age,  when  about  a  month  old,  had  the  small-pox  at  a  time  when  three  others 
of  the  family  had  the  same  disease,  one  of  whom — a  servant  man — died  of  it.  Mr  Lang¬ 
ford’s  countenance  was  strongly  indicative  of  the  malignity  of  the  distemper,  his  face 
being  so  remarkably  pitted  and  seamed,  as  to  attract  the  notice  of  all  who  saw  him,  so 
that  no  one  could  entertain  a  doubt  of  his  having  had  that  disease  in  a  most  inveterate 
manner.” 

Mr.  Withers  proceeds  to  state  that  Mr.  Langford  was  seized  a  second  time,  had  a  bad 
confluent  small-pox,  and  died  on  the  twenty-first  day  from  the  seizure ;  and  that  four  of 
the  family,  as  also  a  sister  of  the  patient’s,  to  whom  the  disease  was  conveyed  by  her 
son’s  visiting  his  uncle,  falling  down  with  the  small-pox,  fully  satisfied  the  country  with 
regard  to  the  nature  of  the  disease,  which  nothing  short  of  this  would  have  done.  The 
sister  died. 

“  This  case  was  thought  so  extraordinary  a  one  as  to  induce  the  rector  of  the  parish  to 
record  the  particulars  in  the  parish  register.” 

It  is  singular  that  in  most  cases  of  this  kind  the  disease  iu  the  first  instance  has  been 
confluent;  so  that  the  extent  of  the  ulceration  on  the  skin  (as  in  the  cow-pox)  is  not 
the  process  in  nature  which  affords  security  to  the  constitution. 

As  the  subject  of  the  small-pox  is  so  interwoven  with  that  which  is  the  more  immediate 
object  of  my  present  concern,  it  must  plead  my  excuse  for  so  often  introducing  it.  At 
present  it  must  be  considered  a  distemper  not  well  understood.  The  inquiry  I  have  in¬ 
stituted  into  the  nature  of  the  cow-pox  will  probably  promote  its  more  perfect  investi¬ 
gation. 

The  inquiry  of  Dr.  Pearson  into  the  history  of  the  cow-pox  having  produced  so  great  a 
number  of  attestations  in  favor  of  my  assertion  that  it  proves  a  protection  to  the  human 
body  from  the  small-pox,  I  have  not  been  assiduous  in  seeking  for  more  ;  but  as  some  of 
my  friends  have  been  so  good  as  to  communicate  the  following,  I  shall  conclude  these 
observations  with  their  insertion. 

Extract  of  a  letter  from  Mr.  Drake,  surgeou,  at  Stroud,  in  this  county,  and  late  sur 
geon  to  the  North  Gloucester  Regiment  of  Militia: 

“In  the  spring  of  the  year  1796  I  inoculated  men,  women  and  children,  to  the  amount 
of  about  seventy.  Many  of  the  men  did  noc  receive  the  infection,  although  inoculated 
at  least  three  times,  and  kept  in  the  same  room  with  those  who  actually  underwent  the 
disease  during  the  whole  time  occupied  by  them  in  passing  through  it.  Being  anxious 
they  should  in  future  be  secure  against  it,  I  was  very  particular  in  my  inquiries  to  find 
out  whether  they  ever  had  previously  had  it,  or  at  any  time  beeu  in  the  neighborhood 
of  people  laboring  under  it.  But,  after  all,  the  only  satisfactory  information  I  could 
obtain  was  that  they  had  had  the  cow-pox.  As  I  was  then  ignorant  of  such  a  disease 
affecting  the  human  subject,  I  flattered  myself  what  they  imagined  to  be  the  cow-pox 
was  in  reality  the  small-pox  in  a  very  slight  degree.  I  mentioned  the  circumstance  in 
the  presence  of  several  of  the  officers,  at  the  same  time  expressing  my  doubts  if  it  were 
not  small-pox,  and  was  not  a  little  surprised  when  I  was  told  by  the  colonel  that  he  had 
frequently  heard  you  mention  the  cow-pox  as  a  disease  endemial  to  Gloucestershire,  and 
that  if  a  person  were  ever  affected  by  it,  you  supposed  him  afterwards  secure  from  the 
small-pox.  This  excited  my  curiosity,  and  when  I  visited  Gloucestershire  I  was  very 
inquisitive  concerning  the  subject;  and  from  the  information  I  have  since  received,  both 
from  your  publication  and  from  conversation  with  medical  men  of  the  greatest  accuracy 
in  their  observations,  I  am  fully  convinced  that  what  the  men  supposed  to  be  the  cow- 
pox,  was  actually  so,  and  1  can  safely  affirm  that  they  effectually  resisted  the  small-pox.” 

Mr.  Fry,  surgeon,  at  Durfley,  in  this  county,  favors  me  with  the  following  communi¬ 
cation  : 

“  During  the  spring  of  the  year  1797,  I  inoculated  fourteen  hundred  and  seventy-five 
patients,  of  all  ages,  from  a  fortnight  old  to  seventy  years,  amongst  whom  there  were 
many  who  had  previously  gone  through  the  cow-pox.  The  exact  number  I  cannot  state, 
but  if  I  say  they  were  near  thirty,  I  am  certainly  within  the  number.  There  was  not  a 
single  instance  of  the  variokms  matter  producing  any  constitutional  effect  on  these  peo¬ 
ple,  nor  any  greater  degree  nf  local  inflammation  than  it  would  have  done  in  the  arm  of 
a  person  who  had  before  gone  through  the  small-pox,  notwithstanding  it  was  invariably 
inserted  four,  five,  and  sometimes  six  different  times,  to  satisfy  the  minds  of  the  patients. 
In  the  common  course  of  inoculation  previous  to  the  general  one,  scarcely  a  year  passed 
without  my  meeting  with  one  or  two  instances  of  persons  who  had  gone  through  the 
cow-pox,  resisting  the  action  of  the  variolous  contagion.  I  may  fairly  say  that  the 
number  of  people  I  have  seen  inoculated  with  the  small-pox,  who  at  former  periods  had 
gone  through  the  cow-pox,  are  not  less  than  forty  and  in  no  one  instance  have  I 


*The  greater  part  of  these  people  must,  of  course,  have  had  the  cow-pox  many  years  before  this  trial 
was  made  upon  them  with  the  matter  of  small-pox. — E.  J. 


Variola  Vaccina  :  Edward  Jenner. 


43 


known  a  patient  receive  the  small -pox,  notwithstanding  they  invariably  continued  to 
associate  with  other  inoculated  patients  during  the  progress  ot  the  disease,  and  many  of 
them  purposely  exposed  themselves  to  the  contagion  of  the  natural  small-pox  ;  whence 
I  am  fully  convinced  that  a  person  who  had  fairly  had  the  cow-pox  is  no  longer  capable 
of  being  acted  upon  by  the  variolous  matter. 

“  I  also  inoculated  a  very  considerable  number  of  those  who  had  had  a  disease  which 
ran  through  the  neighborhood  a  few  years  ago,  and  was  called  by  the  common  people 
the  swine  pox,  not  one  of  whom  received  the  small- pox.* 

“There  were,  about  half  a  dozen  instances  of  people  who  never  had  either  the  cow  or 
swine  pox,  yet  did  not  receive  the  small-pox,  the  system  not  being  in  the  least  deranged, 
or  the  arms  inflamed,  although  they  were  repeatedly  inoculated,  and  associated  with 
others  who  were  laboring  under  the  disease.  One  of  them  was  the  son  of  a  farrier.” 

Mr.  Tierny,  assistant  surgeon  of  tne  South  Gloucester  Regiment  of  Militia,  has  obliged 
me  with  the  following  information: 

“That  in  the  summer  of  the  year  1798,  he  inoculated  a  great  number  of  the  men  be¬ 
longing  to  the  regiment,  and  that  among  them  he  found  eleven,  who,  from  having  lived 
in  dairies,  had  gone  through  the  cow-pox.  That  all  of  them  resisted  the  small-pox,  ex¬ 
cept  one  ;  but  that,  on  making  the  most  rigid  and  scrupulous  inquiry  at  the  farm  in 
Gloucestershire,  where  the  man  said  he  lived  when  he  had  the  disease,  and  among  those 
with  whom  at  the  same  time  he  declared  he  had  associated,  and  particularly  of  a  person 
in  the  parish,  whom  he  said  had  dressed  his  fingers,  it  most  clearly  appeared  that  he 
aimed  at  an  imposition,  and  that  he  never  had  been  affected  with  tliecow-pox.t 

Mr.  Tierney  remarks,  “that  the  arms  of  many  who  were  inoculated,  after  having  had 
the  cow-pox,  inflamed  very  quickly,  and  that  in  several  a  little  ichorous  fluid  was 
formed.” 

Mr.  Cline,  who  in  July  last  was  so  obliging,  at  my  request,  as  to  try  the  efficacy  of 
the  cow-pox  virus,  was  kind  enough  to  give  me  a  letter  on  the  result  of  it,  from  which 
the  following  is  an  extract : 

“ My  Dear  Sir — The  cow-pox  experiment  has  succeeded  admirably.  The  child  sick¬ 
ened  on  the  seventh  day,  and  the  fever,  which  was  moderate,  subsided  on  the  eleventh. 
The  inflammation  arising  from  the  infection  of  the  virus  extended  to  about  four  inches 
in  diameter,  and  then  gradually  subsided,  without  having  been  attended  with  pain  or 
other  inconvenience.  There  were  no  ei-uptions. 

“I  have  since  inoculated  him  with  small-pox  matter  in  three  places,  which  were 
slightly  inflamed  on  the  third  day,  and  then  subsided. 

“Dr.  Lister,  who  was  formerly  physician  to  the  small-pox  hospital,  attended  the  child 
with  me,  and  he  is  convinced  that  it  is  not  possible  to  give  him  the  small-pox,  I  think 
the  substituting  the  cow-pox  poison  for  the  small-pox  promises  to  he  one  of  the  greatest 
improvements  that  has  ever  been  made  in  medicine;  and  the  more  I  think  on  the  subject, 
the  more  I  am  impressed  with  its  importance. 

“With  great  esteem,  I,  am,  etc., 

HENRY  CLINE.” 

Lincoln’s  Inn  Fields,  August  2,  1798. 

From  communications,  with  which  I  have  been  favored  from  Dr.  Pearson,  who  has 
occasionally  reported  to  me  the  result  of  his  private  practice  with  the  vaccine  virus  in 
London,  and  from  Dr.  Woodville,  who  has  also  favored  me  with  an  account  of  his  more 
extensive  inoculation  with  the  same  virus  at  the  small-pox  hospital,  it  appears  that 
many  of  their  patients  have  been  affected  with  eruptions,  and  that  these  eruptions  have 
matured  in  a  manner  very  similar  to  the  variolous.  The  matter  they  made  use  of  was 
taken,  in  the  first  instance,  from  a  cow  belonging  to  one  of  the  great  milk  farms  in  Lon- 
dou.  Having  never  seen  maturated  pustules  produced  either  in  my  own'  practice  among 
those  who  were  casually  infected  by  cows,  or  those  to  whom  the  disease  had  been  com¬ 
municated  by  inoculation,  I  was  desirous  of  seeing  the  effects  of  the  matter  generated 
in  London,  on  subjects  living  in  the  country,  A  thread  imbrued  in  some  of  this  matter 
was  sent  to  me,  and  with  it  two  children  were  inoculated,  whose  casee  I  shall  transcribe 
from  my  notes. 

Stephen  Jenner,  three  years  and  a-half  old. 

Third  Day — The  arm  showed  a  proper  and  decisive  inflammation. 

Sixth  Day — A  vesicle  arising. 

Seventh  Day — The  pustule  of  a  cherry  color. 

Eighth  Day — Increasing  in  elevation.  A  few  spots  now  appear  on  each  arm,  near  the 
insertion  of  the  inferior  tendons  of  the  biceps  muscles.  They  are  very  small  and  of  a 


*This  was  that  mild  variety  of  the  small-pox  which  I  have  noticed  in  the  late  treatise  on  the  cow-pox, 
page  49. 

tThe  public  cannot  be  too  much  on  their  guard  respecting  persons  of  this  description, 


44 


Variokv  Vaccina] :  Edward  Jenner. 


vivid  red  color.  The  pulse  natural;  tongue  of  its  natural  hue ;  no  loss  of  appetite,  or 
any  symptom  of  indisposition. 

Ninth  Day — Inoculated  pustule  on  the  arm  this  evening  began  to  inflame,  and  gave 
the  child  uneasiness.  He  cried  and  pointed  to  the  seat  of  it,  and  was  immediately  after¬ 
wards  affected  with  febrile  symptoms;  at  the  expiration  of  two  hours  after  the  seizure,  a. 
plaster  of  ung.  hydrarg.  fort ,  was  applied,  andits  effect  was  very  quickly  perceptible,  for 
iu  ten  minutes  he  assumed  his  usual  looks  and  playfulness.  On  examining  the  arm  about 
three  hours  after  the  application  of  the  plaster,  its  effect  in  subduing  the  inflammation 
were  very  manifest. 

Tenth — The  spots  on  the  arms  have  disappeared,  but  there  are  three  visible  in  the  face. 

Eleventh — Two  spots  on  the  face  are  gone,  the  other  barely  perceptible. 

Thirteenth— The  pustule  delineated  in  the  second  plate  in  the  treatise  on  Variolse  Vac- 
citne  is  a  correct  representation  of  that  on  the  child’s  arm  as  it  appears  at  this  time. 

Fourteenth — Two  fresh  spots  appear  on  the  face.  The  pustule  on  the  arm  nearly  con¬ 
verted  into  a  scab.  As  long  as  any  fluid  remained  in  it,  it  was  limpid. 

James  Hill,  four  years  old,  was  inoculated  on  the  same  day,  and  with  part  of  the  same 
matter  which  infected  Stephen  Jenner.  It  did  not  appear  to  have  taken  effect  till  the 
fifth  day. 

Seventh — A  perceptible  vesicle.  This  evening  the  patient  became  a  little  chilly  ;  no 
pain  or  tumor  discoverable  in  the  axilla. 

Eighth — Perfectly  well. 

Ninth — The  same. 

Tenth — The  vesicle  more  elevated  than  I  have  been  accustomed  to  see  it,  and  assum¬ 
ing  more  perfectly  the  variolous  character  that  is  common  with  the  cow-pox  at  this 
stage. 

Eleventh — Surrounded  by  an  inflammatory  redness  about  the  size  of  a  shilling,  studded 
over  with  minute  vesicles.  The  pustule  contained  a  limpid  fluid  till  the  fourteenth  day, 
after  which  it  was  encrusted  over  in  the  usual  manner;  but  this  incrustation  or  scab 
being  accidentally  rubbed  off  it  was  slow  in  healing. 

These  children  were  afterwards  fully  exposed  to  the  small-pox  contagion  without 
effect. 

Having  been  requested  by  my  friend,  Mr.  Henry  Hicks,  of  Eastington,  iu  this  county, 
to  inoculate  two  of  his  children,  and  at  the  same  time  some  of  his  servants  and  the  peo¬ 
ple  employed  in  his  manufactry,  matter  was  taken  from  the  arm  of  this  boy  for  the 
purpose.  The  number  inoculated  was  eighteen.  They  a  1  took  the  infection  ;  and, 
either  on  the  fifth  or  sixth  day,  a  vesicle  was  perceptible  on  the  punctured  part.  Some 
of  them  began  to  feel  a  little  unwell  on  the  eighth  day,  but  the  greater  number  on  the 
ninth.  Their  illness,  as  iu  the  former  cases  described,  was  of  short  duration,  and  not 
sufficient  to  interrupt,  but  at  very  short  intervals,  the  children  from  their  amusements, 
or  the  servants  and  manufacturers  from  following  their  ordinary  business. 

Three  of  the  children  whose  employment  in  the  manufactory  was  in  some  degree 
laborious,  had  an  inflammation  on  their  arms  beyond  the  common  b<  undary  about  the 
eleventh  or  twelfth  day,  when  the  feverish  symptoms,  which  before  were  nearly  gone  off", 
again  returned,  accompanied  with  increase  of  axillary  tumors.  In  these  cases  (clearly 
perceiving  the  symptoms  were  governed  by  the  state  of  the  arms),  I  applied  on  the 
inoculated  pustules,  and  renewed  the  application  three  or  four  times  within  an  hour,  a 
pledget  of  lint,  previously  soaked  in  aqua  lythargyri  aeetati,*  and  covered  the  hot  efflor¬ 
escence  surrounding  them  with  cloths  dipped  in  cold  water. 

The  next  day  I  found  that  this  simple  mode  of  treatment  had  succeeded  perfectly.  The 
inflammation  was  nearly  gone  off",  and  with  it  the  symptoms  which  it  had  produced. 

Some  of  these  patients  have  since  been  inoculated  with  variolous  matter  without  any 
effect  beyond  a  little  inflammation  on  the  part  where  it  was  inserted. 

Why  the  arms  of  those  inoculated  with  the  vaccine  matter  iu  the  country  should  be 
more  disposed  to  inflame  than  those  inoculated  in  London,  it  may  be  difficult  to  deter¬ 
mine.  From  comparing  my  own  oases  with  some  transmitted  to  me  by  Dr.  Pearson  and 
Dr.  Woodville,  this  appears  to  be  the  fact,  and  what  strikes  me  as  still  more  extraordi¬ 
nary  with  respect  to  those  inoculated  in  London  is  the  appearance  of  maturating  erup¬ 
tions.  Iu  the  two  instances  only  which  I  have  mentioned  (the  one  from  the  inoculated, 
the  other  from  the  casual  cow-pox)  u  few  red  spots  appeared,  which  quickly  went  off" 
without  maturating.  Tne  case  of  the  Rev.  Mr.  Moore’s  servant  may  indeed  seem  like  a 
deviation  from  the  common  appearances  iu  the  country,  but  the  nature  of  these  erup¬ 
tions  was  not  ascertained  beyond  their  not  possessing  the  property  of  communicating 
the  disease  by  their  effluvia.  Perhaps  the  difference  we  perceive  in  the  state  of  the 
arms  may  be  owing  to  some  variety  in  the  mode  of  action  of  the  virus  from  the  skin  of 
those  who  breathe  the  air  of  London  and  those  who  live  iu  the  country.  That  the  ery¬ 
sipelas  assumes  a  different  form  in  London  from  what  we  see  it  put  on  in  the  country,  is 


*Goulard’s  extract  of  Saturn. 


Variola1  Yaccince  :  Edward  Jenner. 


45 


a  fact  very  generally  acknowledged.  In  calling  the  inflammation  that  is  excited  by  the 
cow-pox  virus  erysipela tons,  perhaps  I  may  not  be  critically  exact,  but  it  certainly  ap¬ 
proaches  near  to  it.  Now,  as  the  disease  going  forward  in  the  part  infected  with  the 
virus  may  undergo  different  modifications  according  to  the  peculiarities  of  the  constitu¬ 
tion  on  which  it  is  to  produce  its  effect,  may  it  not  account  for  the  variation  which  has 
been  observed? 

To  this  it  may  probably  be  objected  that  some  of  the  patients  inoculated  and  who  had 
pustules  in  consequence,  were  newly  come  from  the  country,  but  I  conceive  that  the 
changes  wrought  in  the  human  body,  through  the  medium  of  the  lungs,  may  be  extremely 
rapid  ;  yet,  after  all,  further  experiments  made  in  London  with  vaccine  virus  generated 
in  the  country,  must  finally  throw  a  light  on  what  now  certainly  appears  obscure  and 
mysterious. 

The  principal  variation  perceptible  to  me  in  the  action  of  the  vaccine  virus  generated 
in  London  from  that  produced  in  the  country  was  its  proving  more  certainly  infectious, 
and  giving  a  less  disposition  in  the  arm  to  inflame.  There  appears  also  a  greater  eleva¬ 
tion  of  the  pustule  above  the  surrounding  skin.  In  my  former  cases  the  pustule  pro¬ 
duced  by  the  insertion  of  the  virus  was  more  like  one  of  those  which  are  so  thickly 
spread  over  the  body  in  a  bad  kind  of  confluent  small-pox,  except  that  I  saw  no  instance 
of  pus  being  formed  in  i r,  the  matter  remaining  limpid  till  the  period  of  scabbing 

Wishing  to  see  the  effects  of  the  disease  on  an  infant  newly  born,  my  nephew,  Mr. 
Henry  Jenner,  at  my  request,  inserted  the  vaccine  virus  into  the  arm  of  a  child  about 
twenty  hours  old.  His  report  to  me  is  that  the  child  went  through  the  disease  without 
apparent  illness,  yet  that  it  was  found  effectually  to  resist  the  action  of  variolous  matter 
with  which  it  was  subsequently  inoculated. 

I  have  had  an  opportunity  of  trying  the  effects  of  the  cow-pox  matter  on  a  boy  who, 
the  day  preceding  its  insertion,  sickened  with  the  measles.  The  eruption  of  the  measles, 
attened  with  a  cough,  a  little  pain  in  the  chest,  and  the  usual  symptoms  accompanying 
that  disease,  appeared  on  the  third  day  and  spread  all  over  him.  The  disease  went 
through  its  course  without  any  deviation  from  its  usual  habits;  and,  notwithstanding 
this,  the  cow-pox  virus  exciced  its  common  appearances,  both  on  the  arm  and  on  the 
constitution  without  any  sensible  interruption;  on  the  sixth  there  was  a  vesicle- 

Eighth — Pain  in  the  axilla,  chilly  and  affected  with  headache. 

Ninth — Nearly  well. 

Twelfth  — The  pustule  spread  to  the  size  of  a  large  split  pea,  but  withoutany  surround¬ 
ing  efflor  sence.  It  soon  after  scabbed  and  the  boy  recovered  his  general  health  rapidly. 
But  if  sh  dd  be  observed  that  before  it  scabbed,  the  efflorescence  which  had  suffered  a 
temporal  uispension,  advanced  in  the  usual  manner.  Here  we  see  a  deviation  from  the 
bits  of  the  small-pox,  as  it  has  been  observed  that  the  presence  of  the 
lends  the  action  of  variolous  matter,  however  the  suspension  of  the  efflor- 
orthy  of  observation. 

general  investigation  that  is  now  taking  place  chiefly  through  inoculation 

y  be  conducted  with  that  calmness  and 
losophical  research)  must  soon  place  the 
*■  result  of  all  my  trials  with  the  virus  on 
instance  the  patient  who  lias  felt  its  in- 
or  the  variolous  contagion,  and  as  these 
ve  that,  joined  to  the  observations  in  the 
ude  me  from  the  necessity  of  entering 
d  reports  adverse  to  my  assertion  on  no 
'•ted. 


ordinary 
measles 
esc^hce  i 
The 


(and  1 

repeat  my  earnest  1 

mpe  that  it  m 

modi 

which  should  ev-  r  a 

'■company  a  pi 

vacci 

ase  in  its  just  p<«'u 

of  view.  Th 

the  1 

u  bject  has  been 

rm.  In  ever 

flueu 

•  ompletely  lost  i 

'sceptibilit  \ 

insta 

now  become  n 

•oils,  I  conee 

form 

f  this  paper,  1 1 

ffleiently  pre 

into 

rsis  with  thos' 

ive  eircn 

othei 

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asualh 

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A  CONTINUATION  OF 


✓ 


ERTOTIOI 


RELATIVE  TO  THE 


■cvatOK,  COW  FOX.^W=x> 


EDWARD  JENNER,  M.  D.  F,  R..S.  &C 


LONDON : 

PRINTED  FOR  THE  AUTHOR,  BY  D  N.  SHLTRY,  No.  7  BERWICK  STREET.  SOHO. 

1801. 


A  CONTINUATION  OF  FACTS  AND  OBSERVATIONS,  &C.,  &C. 


Since  my  former  publications  on  vaccine  inoculation,  I  liave  bad  the  satisfaction  of 
seeing  it  extend  very  widely.  Not  only  in  this  country  is  the  subject  pursued  with  ar¬ 
dor,  but  from  my  correspondence  with  many  respectable  medical  gentlemen  on  the  Con¬ 
tinent  (among  whom  are  Dr.  De  Carro,  of  Vienna,  and  Dr.  Ballhorn,  of  Hanover),  I  find 
it  is  as  warmly  adopted  abroad,  where  it  has  afforded  the  greatest  satisfaction.  I  have 
the  pleasure,  too,  of  seeing  that  the  feeble  efforts  of  a  few  individuals  to  depreciate  the 
new  practice  are  sinking  fast  into  contempt  beneath  the  immense  mass  of  evidence 
which  has  risen  up  in  support  of  it. 

Upwards  of  6000  persons  have  now  been  inoculated  with  the  virus  of  cow-pox,  and  the 
far  greater  part  of  them  have  since  been  inoculated  with  that  of  small-pox,  and  exposed 
to  its  infection  in  every  rational  way  that  could  he  devised  without  effect. 

It  was  very  improbable  that  the  investigation  of  a  disease  so  analogous  to  the  small¬ 
pox  should  go  forward  without  engaging  the  attention  of  the  physician  of  the  small- 
hox  hospital  in  London. 

Accordingly,  Dr.  Woodville,  who  fills  that  department  with  so  much  respectability, 
took  an  early  opportunity  of  instituting  an  inquiry  into  the  nature  of  the  cow-pox.  This 
inquiry  was  begun  in  the  early  part  of  the  present  year,  and  in  May  Dr.  Woodville  pub¬ 
lished  the  result,  which  differs  essentially  from  mine  in  a  point  of  much  importance.  It 
appears  that  three-fifths  of  the  patients  inoculated  were  affected  with  eruptions  for  the 
most  part  so  perfectly  resembling  the  small-pox  as  not  to  be  distinguished  from  them. 
On  this  subject  it  is  necessary  that  I  should  make  some  comments. 

When  I  consider  that  out  of  the  great  number  of  cases  of  casual  inoculation  immedi¬ 
ately  from  cows  which  have  from  time  to  time  presented  themselves  to  my  observation 
and  the  many  similar  instances  which  have  been  communicated  to  me  by  medical  gentle¬ 
men  in  this  neighborhood  ;  when  I  consider  that  the  matter  with  which  inoculations 
were  conducted  in  the  years  1797,  1798,  1799,  was  taken  from  different  cows,  and  that  in 
no  instance  anything  like  a  variolous  pustule  appeared. 

I  cannot  feel  disposed  to  imagine  that  eruptions  similar  to  those  described  by  Dr. 
Woodwille,  have  ever  been  produced  by  the  pure,  un contaminated  cow-pox  virus ;  on  the 
contrary,  I  do  suppose  that  those  which  the  doctor  speaks  of  originated  in  the  action  of 
variolous  matter,  which  crept  into  the  constitution  with  the  vaccine.  And  this  I  pre¬ 
sume  happened  from  the  inoculation  of  a  great  number  of  the  patients  with  variolous 
matter,  (some  on  the  third,  others  on  the  fifth  day),  after  the  vaccine  had  been  applied  ; 
and  it  should  be  observed,  that  the  matter  thus  propagated  became  the  source  of  future 
inoculations  in  the  hands  of  many  medical  gentlemen  who  appeared  to  have  been  pre¬ 
viously  unacquainted  with  the  nature  of  the  cow-pox. 

Another  circumstance  strongly,  in  my  opinion,  supporting  this  supposition  is  the  fol¬ 
lowing  :  The  cow-pox  has  been  known  among  our  dairies  time  immemorial.  If  pustules 
then,  like  the  variolous,  were  to  follow  the  communication  of  it  from  the  cow  to  the 
milker,  would  not  such  a  fact  have  been  known,  and  recorded  at  our  farms  ?  Yet  neither 
our  farmers  nor  the  medical  people  of  the  neighborhood  have  noticed  sue'h  occurence. 

A  few  scattered  pimples,  I  have  some  times  though  very  rarely,  seen,  the  greater  part  of 
which  have  generally  disappeared  quickly,  hut  some  have  remained  long  enough  to  sup¬ 
purate  at  their  apex.  The  cuticular  inflammation,  whether  springing  up  spontaneously  or 
arising  from  the  application  of  acrid  substances,  such,  for  instauce  as  Cantharides,  Pix  Bur- 
guydica,  Antimonium  Tartavizatum,  etc.,  will  often  produce  cutaneous  affections,  not  only 
near  the  seat  of  the  inflammation, Jbut  on  some  parts  of  the  skin  far  beyond  its  boundary,  is  a 
well-known  fact.  It  is,  doubtless,  on  this  principle  that  the  inoculated  cow-pox  pustule 
and  its  concomitant  efflorescence  may  in  very  irritable  constitutions  produce  this  affec¬ 
tion.  The  eruption  I  allude  to  has  commonly  appeared  sometimes  in  the  third  week 
after  inoculation,  but  this  appearance  is  too  trivial  to  excite  the  least  regard. 

The  change  which  took  place  in  the  general  appearance  during  the  progress  of  the 
vaccine  inoculation  at  the  small-pox  hospital  should  likewise  be  considered. 

Although  at  first  it  took  on  so  much  of  the  variolous  character,  as  to  produce  pus¬ 
tules  in  three  csase  out  of  five,  yet  in  Dr.  Woodville’s  last  report,  published  in  June,  he 
says:  “  Since  the  publication  of  my  reports  of  inoculations  for  the  cow-pox,  upwards 
of  300  cases  have  been  under  my  care,  and  out  of  this  number  only  thirty-nine  had  pustules 


50 


Variolce  Vaccince :  Edward  Jenner. 


that  suppurated,  namely,  out  of  the  first  hundred,  nineteen  had  pustules ;  out  of  the  second 
thirteen ;  and  out  of  the  last  hundred  and  ten,  only  seven  had  pustules.  Thus  it  appears 
that  the  disease  has  been  considerably  milder,  which  I  am  inclined  to  attribute  to  a 
greater  caution  used  in  the  choice  of  the  matter  with  which  the  infection  was  communi¬ 
cated,  for  lately  that  which  has  been  employed  for  this  purpose  has  been  taken  only 
from  those  patients  In  whom  the  cow-pox  proved  very  mild  and  well  characterized.* * 

The  inference  I  am  induced  to  draw  from  these  premises  is  very  different.  The  decline 
and  finally  the  total  extinction  nearly  of  these  pustules  in  my  opinion  are  more  fairly 
attributable  to  the  cow-pox  virus  assimilating  the  variolous,!  the  former  being  the  orig¬ 
inal,  the  latter  the  same  disease  under  a  peculiar  and  at  present  an  unexplicable  modifi¬ 
cation. 

One  experiment  tending  to  elucidate  the  point  under  discussion, I  had  myself  an  oppor¬ 
tunity  of  instituting.  On  the  supposition  of  its  being  possible  that  the  cow  which 
ranges  over  the  fertile  meadows  in  the  vale  of  Gloucester,  might  generate  a  virus  differ¬ 
ent  in  some  respects  in  its  qualities  from  that  produced  by  the  animal  artificially  pam¬ 
pered  for  the  production  of  milk  for  the  metropolis,  I  procured  during  my  residence 
there  in  the  spring,  some  cow-pox  virus  from  a  cow  at  one  of  the  London  milk  farms.! 
It  was  immediately  conveyed  into  Gloucestershire  to  Dr  Marshall,  who  was  then  exten¬ 
sively  engaged  in  the  inoculation  of  the  cow-pox,  the  general  result  of  which,  and  of 
inoculation  in  particular,  with  this  matter,  I  shall  lay  before  my  readers  in  the  following 
communication  from  the  doctor  : 

“ Dear  Sir — My  neighbor,  Mr.  Hicks,  having  mentioned  your  wish  to  be  informed  of 
the  progress  of  inoculation  here  for  the  cow-pox,  and  he  also  having  taken  the  trouble 
to  transmit  to  you  my  minutes  of  the  cases  which  have  failen  under  my  care,  I  hope  you 
will  pardon  the  trouble  I  now  give  you  in  stating  the  observations  I  have  made  upon  the 
subject.  When  first  informed  of  it,  having  two  children  who  had  not  had  the  small-pox 
I  determined  to  inoculate  them  for  the  cow-pox  whenever  I  should  be  so  fortunate  as  to 
procure  matter  proper  for  the  purpose.  I  was,  therefore,  particularly  happy  when  I  was 
informed  that  I  could  procure  matter  from  some  of  those  whom  you  had  inoculated.  In 
the  first  instance  I  had  no  intention  of  extending  the  disease  further  than  my  own  family, 
but  the  very  extensive  influence  which  the  conviction  of  its  efficacy  in  resisting  the 
small-pox  has  had  upon  the  minds  of  the  people  in  general,  has  rendered  that  intention 
nugatory,  as  you  will  perceive  by  the  continuation  of  my  cases,  inclosed  in  this  letter,  || 
by  which  it  will  appear  that  since  the  twenty-second  of  March,  I  have  inoculated  an 
hundred  and  seven  persons,  which,  considering  the  retired  situation  I  reside  in,  is  a  very 
great  number.  There  are  also  other  considerations  which,  besides  that  of  its  influence 
in  resisting  the  small-pox,  appears  to  have  had  their  weight,  namely,  the  peculiar  mild¬ 
ness  of  the  disease,  the  known  safety  of  it,  and  its  not  having  in  any  instance  prevented 
the  patient  from  following  his  ordinary  business.  In  all  the  cases  under  my  care  there 
have  only  occurred  two  or  three  which  required  any  application,  owing  to  erysipelatous 
inflammation  on  the  arm,  and  they  immediately  yielded  to  it.  In  the  remainder  the  con¬ 
stitutional  illness  has  been  slight,  but  sufficiently  marked  and  considerably  less  than  I 
ever  observed  in  the  same  number  inoculated  with  the  sinall-pox.  In  only  one  or  two 
of  the  cases  have  any  other  eruptions  appeared  than  those  around  the  spot  where  the 
matter  was  inserted,  and  those  near  the  infected  part.  Neither  does  there  appear  in  the 
cow-pox  to  be  the  least  exciting  cause  to  any  other  disease,  which  in  the  small-pox  has 
been  frequently  observed,  the  constitution  remaining  in  as  full  health  and  vigor  after  the 
termination  of  the  disease  as  before  the  infection.  Another  important  consideration 
appears  to  be  the  impossibility  of  the  disease  being  communicated  except  by  actual  con¬ 
tact  of  the  matter  of  the  pustule,  and  consequently  the  perfect  safety  of  the  remaining 
part  of  the  family,  supposing  only  one  or  two  should  wish  to  be  inoculated  at  the  same 
time. 

Upon  the  whole  it  appears  evident  to  me  that  the  cow-pox  is  a  pleasanter,  shorter  and 
infinitely  more  safe  disease  than  the  inoculated  small-pox,  when  conducted  in  the  most 
careful  and  approved  manner,  neither  is  the  local  affection  of  the  inoculated  part  or 
the  constitutional  illness  near  so  violent.  I  speak  with  confidence  on  the  subject,  having 
had  an  opportunity  of  observing  its  -effect  upon  a  variety  of  constitutions,  from  three 

*In  a  few  days  after  tlie  cow-pox  inoculation  was  introduced  at  the  small-pox  hospital  I  was  favored  with 
some  virus  from  this  stock.  In  the  first  instance  it  produced  a  few  pustules,  which  did  not  maturate,  but 

•  n  the  subsequent  cases  none  appeared. 

fin  my  first  publication  on  this  subject  I  expressed  an  opinion  that  the  cow-pox  and  the  small-pox  were 
the  same  diseases  under  different  modifications.  In  this  opinion  Ur.  Woodville  has  concurred.  The 
axiom  of  the  immortal  Hunter  that  “two  diseased  actions  cannot  tako  place  at  the  same  time  in  one  and 
the  same  part,”  will  not  be  injured  by  the  admission  of  this  theory. 

jit  was  taken  by  Mr.  Tanner,  then  resident  student  at  the  Veterinary  College,  from  a  cow  at  Mr. 
Clark’s  farm  at  Kentish  town. 

||Dr.  Marshall  has  detailed  these  cases  with  great  accuracy,  but  their  publication  would  now  be  deemed 
superfluous. — E.  J. 


Variolce  Vaccince  :  Edward  Jenner. 


51 


months  old  to  sixty  years,  and  to  which  I  have  paid  particular  attention.  In  the  cases 
alluded  to  here,  you'will  observe  that  the  removal  from  the  original  source  of  the  matter 
has  made  jho  alteration  or  change  in  the  nature  or  appearance  of  the  disease,  and  that  it 
may  be  continued  ad  infinitum  (I  imagine)  from  one  person  to  another  (if  care  be  observed 
in  taking  the  matter  at  a  proper  period)  without  any  necessity  of  recurring  to  the  original 
matter  of  the  cow. 

I  should  be  happy  if  any  endeavors  of  mine  could  tend  further  to  elucidate  the  subject, 
and  shall  be  much  gratified  in  sending  you  any  further  observations  I  may  be  enabled 
to  make.  I  have  the  pleasure  to  subscribe  myself,  dear  sir,  etc., 

JOSEPH  H.  MARSHALL. 

Eastington,  Gloucestershire,  April  26,  1799. 


The  gentleman  who  has  favored  me  with  the  above  accounts,  has  continued  to  prose¬ 
cute  his  inguiries  with  unrelenting  industry,  and  has  communicated  the  result  in  another 
letter,  which,  at  his  request,  I  lay  before  the  public  without  abbreviation. 

DR.  MARSHALL’S  SECOND  LETTER. 

“ Dear  Sir — Since  the  date  of  my  former  letter,  I  have  continued  to  inoculate  with  the 
cow-pox  virus.  Including  the  cases  before  enumerated,  the  number  now  amounts  to  four 
hundred  and  twenty-three.  It  would  be  tedious  and  useless  to  detail  the  prooress  of  the 
disease  in  each  individual — it  is  sufficient  to  observe,  that  I  noticed  no  deviation  in  any 
respect  from  the  cases  I  formerly  adduced.  The  general  appearances  of  the  arm  exactly 
correspond  with  the  account  given  in  your  first  publication.  When  they  were  disposed 
to  become  troublesome  by  erysipalatous  inflammation,  an  application  of  equal  parts  of 
vinegar  and  water  always  answered  the  desired  intention.  1  must  not  omit  to  inform 
you,  that  when  the  disease  had  dnly  acted  upon  the  constitution,  I  have  frequently  used 
the  vitriolic  acid.  A  portion  of  a  drop  applied  with  the  head  of  a  probe  or  any  conven¬ 
ient  utensil,  upon  the  pustule,  suffered  to  remain  about  forty  seconds  and  afterwards 
washed  off  wtih  sponge  and  water,  never  fail  to  stop  its  progress  and  expedite  formation 
of  a  scab. 

“  I  have  already  subjected  two  hundred  and  eleven  of  my  patients  to  the  action  of 
variolous  matter,  but  every  one  resisted  it. 

“The  result  of  my  experiments  (which  were  made  with  every  requisite  caution)  has 
fully  convinced  me  that  the  true  cow-pox  is  a  safe  and  infalible  preventive  from  the 
small-pox  ;  that  in  no  case  which  has  fallen  under  my  observation  has  it  been  in  any  con¬ 
siderable  degree  troublesome,  much  less  have  I  seen  anything  like  danger  ;  for  in  no  in¬ 
stance  were  the  patients  prevented  from  their  ordinary  employments. 

“In  Dr.  Wood ville’s  publication  on  the  cow-pox,  I  notice  an  ordinary  fact.  He  says 
that  the  generality  of  his  patients  had  pustules.  It  certainly  appears  extremely  extra¬ 
ordinary  that  in  all  my  cases  there  never  was  but  one  pustule  which  appeared  on  a 
patient’s  elbow  on  the  inoculated  arm,  and  maturated.  It  appeared  exactly  like  that  on 
the  incised  part. 

“The  whole  of  my  observations,  founded  as  it  appears  on  extensive  experience,  leads 
me  to  these  obvious  conclusions;  that  those  cases  which  have  been  or  may  be  adduced 
against  the  preventive  powers  of  the  cow-pox,  could  not  have  been  those  of  the  true 
kind,  since  it  must  happen  to  be  absolutely  impossible  that  I  should  have  succeeded  in 
such  a  number  of  cases  without  a  single  exception,  if  such  a  preventive  power  did  not 
exist.  I  cannot  entertain  a  doubt  that  the  inoculated  cow-pox  must  quickly  supercede 
that  of  small-pox.  If  the  many  important  advantages  which  must  result  from  the  new 
practice  are  considered,  we  may  reasonably  infer  that  public  benefit,  that  sure  test  of  the 
real  merit  of  discoveries,  Avill  render  it  generally  extensive. 

“To  you,  sir,  as  the  discoverer  of  this  highly- beneficial  practice,  mankind  are  under 
the  highest  obligations.  As  a  private  individual,  I  participate  in  the  general  feeling  ; 
more  particularly  as  you  have  afforded  me  an  opportunity  of  noticing  the  effects  of  a 
singular  disease,  and  of  viewing  the  progress  of  the  most  curious  experiment  that  ever 
was  recorded  in  the  history  of  physiology.  • 

“  I  remain,  dear  sir,  etc.. 

'  “JOSEPH  H.  MARSHALL. 

P.  S.  I  should  have  observed  that  of  the  patients  I  inoculated  and  enumerated  in 
luy  letter,  one  hundred  and  twenty-seven  were  infected  with  the  matter  you  sent  me 
from  the  London  cow.  I  discovered  no  dissimilarity  of  symptoms  in  those  cases,  from 
those  which  I  inoculated  from  matter  procured  in  this  county.  No  pustules  have  oc- 
curred,  except  in  one  or  two  cases,  where  a  single  one  appeared  on  the  inoculated  arm.  No 
difference  was  apparent  m  the  local  inflammation.  There  was  no  suspension  of  ordinary 
employment  among  the  laboring  people,  nor  was  any  medicine  required. 

“I  have  frequently  inoculated  one  or  two  in  a  family,  and  the  remaining  part  of  it 
some  weeks  afterwards.  The  uninfected  have  slept  with  the  infected  during  the  whole 
course  of  the  disease  without  feeling  it ;  so  that  I  am  fully  convinced  the  disease  cannot 
be  taken  but  by  actual  contact  with  the  matter. 


52 


Variola  Vaccina :  Edward  Jennet. 


“A  curious  fact  has  lately  fallen  under  my  observation,  on  which  I  leave  you  to  com¬ 
ment  : 

“I  visited  a  patient  with  the  confluent  small-pox,  and  charged  a  lancet  with  some  of 
the  matter.  Two  days  afterwards  I  was  desired  to  inoculate  a  woman  and  four  children 
With  the  cow-pox,  and  I  inadvertently  took  the  vaccine  matter  on  the  same  lancet  which 
was  before  charged  with  that  of  small-pox.  In  three  days  I  discovered  the  mistake,  and 
fully  expected  that  my  five  patients  would  be  infected  with  small-pox;  but  I  was  agree¬ 
ably  surprised  to  find  the  disease  to  be  the  genuine  cow-pox,  which  proceeded  without 
deviating  in  any  particular  from  my  former  cases,  I  afterwards  inoculated  these  patients 
with  variolous  matter,  but  all  of  them  resisted  its  actiou. 

“  I  omitted  mentioning  another  great  advantage  that  now  occurs  to  me  in  the  inocu¬ 
lated  cow-pox  ;  I  mean  the  safety  with  which  pregnant  women  may  have  the  disease 
communicated  to  them.  I  have  inoculated  a  great  many  females  in  that  situation,  and 
never  observed  their  cases  to  differ  in  any  respect  from  those  of  my  own  patients.  In¬ 
deed  the  disease  is  so  mild,  that  it  seems  as  if  it  might  at  all  times  be  communicated 
with’ the  most  pertect  safety.” 

I  shall  here  take  the  opportunity  of  thanking  Dr.  Marshall  and  those  other  gentlemen 
who  have  obligingly  presented  me  with  the  result  of  their  inoculations  ;  but,  as  they  all 
afree  in  the  same  point  as  that  given  in  the  above  communication,  namely,  the  security 
of  the  patient  from  the  effects  of  the  small-pox  after  the  cow-pox,  their  perusal,  I  pre¬ 
sume  would  afford  us  satisfaction  that  has  not  been  amply  given  already.  Particular 
occurrences  I  shall  of  course  detail.  Some  of  my  correspondents  have  mentioned  the 
appearance  of  small-pox-like  eruptions  at  the  commencement  of  their  inoculations  ;  but 
in  these  cases  the  matter  was  derived  from  the  original  stock  at  the  small-pox  hospital. 

I  have  myself  inoculated  a  very  considerable  number  from  the  matter  produced  by  Dr. 
Marshall’s  patients,  originating  in  the  London  cow,  without  observing  pustules  of  any 
kind  and  have  dispersed  it  among  others  who  have  used  it  with  a  similar  effect.  From 
this  source  Mr.  H.  Jenner  informs  me,  he  has  inoculated  an  hundred  patients  without 
observing  eruption.  Whether  the  nature  of  the  virus  will  undergo  any  change  from 
bein<>’  farther  removed  from  its  original  source,  in  passing  successfully  from  one  person  to 
another  time  alone  can  determine.  That  which  Ijjam  now  employinaghas  been  in  use  near 
eight  months,  and  not  the  least  change  is  perceptible  in  its  mode  of  action,  either  locally 
or  constitutionally.  There  is,  therefore,  every  reason  to  expect  that  its  effects  will  re¬ 
main  unaltered,  and  that  we  shall  not  be  under  the  necessity  of  seeking  fresh  supplies 
from  the  cow . 

The  following  observations  were  obligingly  sent  me  by  Mr.  Tierny  assistant  surgeon 
to  the  South  Gloucester  Regiment  of  Militia,  to  whom  I  am  indebted  for  a  former  report 
on  this  subject : 

“I  inoculated  with  the  cow-pox  matter,  from  the  eleventh  to  the  latter  part  of  April 
twenty-five  persons  including  women  and  children.  Some  on  the  eleventh  were  inocu¬ 
lated  with  the  matter,  Mr.  Shrapnell  (surgeon  to  the  regiment)  had  from  you,  the  others 
with  matter  taken  from  these.  The  progress  of  the  punchette  was  accurately  observed, 
and  its  appearance  seemed  to  differ  from  the  small-pox  in  having  less  inflammation  around 
its  basis  on  the  first  days,  that  is,  from  the  third  to  the  seventh,  but  after  this  the  in¬ 
flammation  increased,  extending  on  the  tenth  or  eleventh  day  to  a  circle  of  an  inch  and 
a-half  fromits  centre,  and  threatening  very  sore  arms;  butthis,  I  am  happy  to  say,  wasnot 
the  case  for,  by  applying  mercurial  ointment  to  the  inflamed  part,  which  was  repeated 
dailv  until  the  inflammation  went  off,  the  arm  got  well  without  any  further  application  or 
trouble.  The  constitutional  symptoms  which  appeared  on  the  eighth  or  ninth  day  after 
inoculation,  scarcely  deserved  the  name  of  disease,  as  they  were  so  slight  as  to  be  barely 
’.perceptible,’  ecept  that  I  could  connect  a  slight  headache  aud  langour  with  a  stiffness; 
and  rather  painful  sensation  in  the  axilla.  This  latter  symptom  was  the  most  striking 
it  remained  from  twelve  to  forty-eight  hours.  In  no  case  did  I  observe  the  smallest 
pustule  or  even  discoloration  of  the  skin  like  an  incipient  pustule,  except  about  the  part 
?  where  the  virus  had  been  applied. 

After  all  these  symptons  had  subsided  and  the  arms  were  well,  I  inoculated  four  of  this 
number  with  variolous  mattter  taken  from  a  patient  in  another  regiment.  In  each  of 
these  it  was  inserted  several  times  under  the  cuticle,  producing  slight  inflammation  on  the 
second  or  third  day,  and  always  disappearing  before  the  fifth  or  sixth  ;  except  in  one  who 
had  the  cow-pox  in  Gloucestershire  before  he  joined  us,  and  wTho  also  received  it  at  this 
time  by  inoculation.  In  this  man  the  puncture  inflamed,  and  his  arm  was  much  sorer 
than  from  the  infection  of  the  cow-pox  virus,  but  there  was  no  pam  in  the  axilla,  nor 
,  could  any  constitutional  affection  be  observed.  ' 

“I  have  only  to  add  that  lam  now  fully  satisfied  of  the  efficacy  of  the  cow-pox  in 
preventing  the  appearance  of  the  small-pox,  and  that  it  is  a  most  happy  and  salutory 
substitute  for  it. 

“I  remain,  etc.,  “M.  J.  TIERNY, 


Yariolce  Vciccince  :  Edward  Jenner. 


53 


Although  the  susceptibility  of  the  virus  of  the  cow-pox  is  for  the  most  part  lost  in 
those  who  have  had  the  small-pox,  yet  in  some  constitutions  it  is  only  partially  de¬ 
stroyed,  and  in  others  it  does  not  appear  to  be  in  the  least  diminished. 

By  far  the  greater  number  on  whom  trials  were  made  resisted  it  entirely  ;  yet  I  found 
some  ou  whose  arms  the  pustule,  from  inoculation,  was  formed  completely,  but  without 
producing  the  common  efflorescent  blush  around  it,  or  any  constitutional  illness,  while 
others  have  had  the  disease  in  the  most  perfect  manner.  A  case  of  the  latter  kind  hav¬ 
ing  been  presented  tome  by  Mr.  Fewster,  Surgeon,  of  Thornbury,  I  shall  insert  it: 

“  Three  children  were  inoculated  with  the  vaccine  matter  you  obligingly  sent  me.  On 
•  calling  to  look  at  their  arms  three  days  after,  I  was  told  that  John  Hodges,  one  of  the 
three,  had  been  inoculated  with  tne  small-pox  when  a  year  old,  and  that  he  had  a  full 
burthen,  of  which  his  face  produced  plentiful  marks,  a  circumstance  I  was  not  before 
made  acquainted  with.  Ou  the  sixth  day  the  arm  of  this  boy  appeared  as  if  inoculated 
with  variolous  matter,  but  the  pustule  was  rather  more  elevated.  On  the  ninth  day  he 
complained  of  violent  pain  in  his  head  and  back,  accompanied  with  vomiting  and  much 
fever.  The  next  day  he  was  very  well,  and  went  to  work  as  usual.  The  punctured  part 
began  to  spread,  and  there  was  the  areola  around  the  inoculated  part  to  a  considerable 
extent. 

“  As  this  is  contrary  to  an  assertion  made  in  the  Medical  and  Physicial  Journal,  No.  8, 1 
thought  it  right  to  give  you  this  information,  and  remain, 

‘‘Dear  Sir,  etc.,  “J.  FEWSTER.” 

It  appears,  then,  that  the  animal  economy,  with  regard  to  the  action  of  this  virus, 
is  under  the  same  laws  as  it  is  with  respect  to  the  variolous  virus,  after  previously  feel¬ 
ing  its  influence,  as  far  as  comparisons  can  be  made  between  two  diseases. 

Some  striking  instances  of  the  power  of  the  cow-pox  in  suspending  the  progress  of  the 
small-pox,  after  the  patients  had  been  several  days  casually  exposed  to  the  infection 
have  been  laid  before  me  by  Mr.  Lyford,  Surgeon,  of  Winchester,  and  my  nephew,  the 
Rev.  G.  C.  Jenner.  Mr.  Lyford,  after  giving  an  account  of  his  extensive  and  successful 
practice  in  the  vaccine  inoculation  iu  Hampshire,  wwites  as  follows  : 

“  The  following  case  occurred  to  me  a  short  time  since,  and  may  probably  be  worth 
your  notice.  I  was  sent  for  to  a  patient  with  the  small-pox,  and  on  inquiry  found  that, 
five  days  previous  to  my  seeing  him,  the  eruption  began  to  appear.  During  the  whole 
of  this  time,  two  children,  who  had  not  had  the  small-pox,  were  constantly  in  the  room 
with  their  father,  and  frequently  on  the  bed  with  him.  The  mother  consulted  me  on  the 
propriety  ot  inoculating  them,  but  objected  to  my  taking  the  matter  from  their  father,  as 
he  was  subject  to  erysipelas.  I  advised  her  by  all  means  to  have  them  inoculated  at  that 
time,  as  I  could  not  procure  any  variolous  matter  elsewhere.  However,  they  were  inocu¬ 
lated  with  vaccine  matter ;  but  I  cannot  say  I  flattered  myself  with  its  proving  success¬ 
ful,  as  they  had  previously  been  so  loug,  and  still  continued  to  be,  exposed  to  the  vario¬ 
lous  infection. 

Notwithstanding  this,  I  was  agreeably  surprised  to  find  the  vaccine  disease  advance 
and  go  through  its  regular  course  ;  and,  if  I  may  be  allowed  the  expression  to  the  total 
extinction  of  the  small -pox. 

Mr.  Jenner’s  cases  were  not  less  satisfactory.  He  writes  as  follows : 

“A  son  of  Thomas  Stinchcomb,  of  Woodford,  near  Berkeley,  was  infected  with  the 
naturaTsmall-pox  at  Bristol,  and  came  to  his  father’s  cottage.  Four  days  after  the  erup¬ 
tions  had  appeared  upon  the  boy,  the  family  (none  of  which  had  ever  had  the  small-pox), 
consisting  of  the  father,  mother,  and  five  children,  were  inoculated  with  vaccine  virus. 
On  the  arm  of  the  mother  it  failed  to  produce  the  least  effect,  and  she  of  course  had  the 
suiall-pox  ;*  but  the  rest  of  the  family  had  the  cow-pox  in  the  usual  mild  way,  and  were  not 
affected  with  the  small-pox,  although  they  were  in  the  same  room,  and  the  children  slept 
in  the  same  bed  with  their  brother,  who  was  confined  to  it  with  the  natural  small-pox; 
and  subsequently  with  their  mother. 

“  I  attended  this  family  with  my  brother,  Mr.  H.  Jenner.” 

The  following  cases  are  of  too  singular  a  nature  to  remain  unnoticed. 

Miss  R - ,  a  young  lady  about  five  years  old,  was  seized,  on  the  evening  of  the 

eighth  day  after  inoculation  with  vaccine  virus,  with  such  symptoms  as  commonly  de¬ 
note  the  accession  of  violent  fever.  Her  throat  was  also  a  little  sore,  and  there  were 
some  uneasy  sensations  about  the  muscles  of  the  neck.  The  day  following  a  rash  was 
perceptible  on  her  face  and  neck,  so  much  resembling  the  efflorescence  of  the  Scarlatina 
Anginosa,  that  I  was  induced  to  ask  whether  Miss  R -  had  been  exposed  to  the  con¬ 

tagion  of  that  disease.  An  answer  in  the  affirmative,  and  the  rapid  spreading  of  the 
redness  over  the  skin,  at  once  relieved  me  from  much  anxiety  respecting  the  nature  of 
the  malady,  which  went  through  its  course  iu  the  ordinary  way,  but  not  without  symp¬ 
toms  which  were  alarming,  both  to  myself  and  Mr.  Lyford,  "who  attended  with  me. 

*Under  similar  circumstances,  I  think  it  would  be  advisable  to  insert  the  matter  into  each  arm,  which 
would  be  more  likely  to  insure  the  success  of  the  matter. — E.  J. 


54 


Variolce  Vaccince :  Edward  Jenner. 


There  was  no  apparent  deviation  in  the  ordinary  i>rogress  of  the  pustule  to  a  state  of 
maturity,  from  what  we  see  in  general ;  yet  there  was  a  total  suspension  of  the  Areola, 
or  florid  discoloration  around  it,  until  the  Scarlatina  had  retired  from  the  constitution. 
As  soon  as  the  patient  was  freed  from  this  disease,  this  appearance  advanced  in  the 
usual  way.* 

The  case  of  Miss  H - R - is  not  less  interesting  than  that  of  her  sister  above  re¬ 

lated.  She  was  exposed  to  the  contagion  of  the  Scarlatina  at  the  same  time,  and  sick¬ 
ened  almost  at  the  same  hour.  The  symptoms  continued  severe  about  twelve  hours,  when 
the  scarlatina  rash  showed  itself  faintly  upon  her  face,  and  partly  upon  her  neck.  After 
remaining  two  or  three  hours  it  suddenly  disappeared,  and  she  became  perfectly  free 
from  every  complaint.  My  surprise  at  this  sudden  transition  from  extreme  sickness  to 
health  in  great  measure  ceased,  when  I  observed  that  the  inoculated  pustule  had  occa¬ 
sioned  in  this  case,  the  common  efflorescent  appearance  around  it,  and  that  as  it  approached 
the  centre,  it  was  nearly  in  an  erysipelatous  state.  But  the  remarkable  part  of  this  history 
is,  that  on  the  fourth  day  afterwards,  as  soon  as  the  efflorescence  began  to  die  away  upon 
the  arm,  and  the  pustule  to  dry  up,  the  Scarlatina  again  appeared,  her  throat  became 
sore,  the  rash  spread  all  over  her.  She  went  fairly  through  the  disease,  with  its  common 
symptoms. 

That  these  were  actually  cases  of  scarlatina  was  rendered  certain  by  two  servants  in 
the  family  falling  ill  at  the  same  time  with  the  distemper,  who  had  been  exposed  to  the 
infection  with  the  young  ladies. 

Some  there  are  who  suppose  the  security  from  the  small-pox  obtained  through  the  cow- 
pox  will  be  of  a  temporary  nature  only.  This  supposition  is  refuted,  not  only  by  analogy 
with  respect  to  the  habits  of  diseases  of  a  similar  nature,  but  by  incontroventible  facts, 
which  appear  in  great  numbers  against  it.  To  those  already  adduced  in  the  former  part 
of  my  first  Treatise,  many  more  might  be  added  were  it  deemed  necessary  ;  but  among 
the  cases  I  refer  to,  one  will  be  found  of  a  person  who  had  the  cow-pox  fifty-three  years 
before  the  olfect  of  the  small-pox  was  tried  upon  him.  As  he  completely  resisted  it,  the 
intervening  period  I  conceive  must  necessarily  satisfy  any  reasonable  mind.  Should 
further  evidence  be  thought  necessary,  I  shall  observe,  that  among  the  cases  presented  to 
me  by  Mr.  Fry,  Mr.  Darke,  Mr  Tierny,  Mr.  H.  Jenner,  and  others,  there  were  many  whom 
they  inoculated  ineffectually  with  variolous  matter,  who  had  gone  through  the  cow-pox 
many  years  before  this  trial  was  made. 

It  has  been  imagined  that  the  cow-pox  is  capable  of  being  communicated  from  one  per¬ 
son  to  another  by  effluvia  without  the  intervention  of  inoculation.  My  experiments 
made  with  the  design  of  ascertaining  this  important  point,  all  tend  to  establish  my  or¬ 
iginal  position,  that  it  is  not  infectious,  except  by  contact.  I  have  never  hesitated  to 
suffer  those,  on  whose  arms  there  were  pustules  exhaling  the  effluvia,  from  associating 
or  even  sleeping  with  others  who  never  had  experienced  either  the  cow-pox  or  the  small¬ 
pox,  and  further,  I  have  repeatedly,  among  children,  caused  the  uninfected  to  breathe 
over  the  inoculated  vaccine  pustules  during  their  whole  progress;  yet  these  experiments 
were  tried  without  the  least  effect.  However,  to  submit  a  matter  so  important  to  a  still 
further  scrutiny,  I  desired  Mr.  H.  Jenner  to  make  any  further  experiments  which  might 
strike  him  as  most  likely  to  establish  or  refute  what  had  been  advanced  on  this  subject. 
Pie  has  since  informed  me,  “that  the  inoculated  children  at  the  breast,  whose  mothers 
had  not  gone  through  either  the  small-pox  or  cow-pox,  that  he  had  inoculated  mothers 
whose  sucking  infants  had  never  undergone  either  of  these  diseases;  that  the  effluvia 
from  the  inoculated  pustules,  in  either  case,  had  been  inhaled  from  day  to  day  during 
the  whole  progress  of  their  maturation,  and  that  there  was  not  the  least  perceptible 
effect  from  these  exposures.  One  woman  he  inoculated  about  a  week  previous  to  her 
accouchement,  that  her  infant  might  be  the  more  fully  and  conveniently  exposed  to  the 
pustule;  but  as  in  the  former  instances,  no  infection  was  given,  although  the  child  fre¬ 
quently  slept  on  the  arm  of  its  mother,  tvitli  its  nostrils  and  mouth  exposed  to  the  pus¬ 
tule  in  the  fullest  state  of  maturity,  In  a  word,  is  it  not  impossible  for  the  cow-pox, 
whose  only  manifestation  appears  to  consist  in  the  pustules  created  by  Contact,  to  produce 
itself  by  effluvia. 

In  the  course  of  a  late  inoculation,  I  observed  an  appearance  which  it  may  be  proper 
here  to  relate.  The  punctured  part  on  a  boy’s  arm  (who  was  inocculated  with  fresh  lim¬ 
pid  virus)  on  the  sixth  day,  instead  of  showing  a  beginning  vesicle,  which  is  usual  in  the 
cow-pox  at  that  period,  was  encrusted  over  with  a  rugged  amber-colored  scab.  The 
scab  continued  to  spread  and  increase  in  thickness  for  some  days,  when  at  its  edges  a 
vesicated  ring  appeared,  and  the  disease  went  through  its  ordinary  course,  the  boy 
having  had  soreness  in  the  axilla,  and  some  slight  indisposition.  With  the  fluid  matter 
taken  from  his  arm,  five  persons  were  inoculated.  In  one  it  took  no  effect.  In  another 


*1  witnessed  a  similar  fact  in  a  case  of  measles.  The  pustule  from  the  cow-pox  virus  advanced  to  ma¬ 
turity,  while  the  measles  existed  in  the  constitution,  but  no  efflorescence  appeared  around  it  until  tho 
measles  had  ceased  to  exert  its  influence. 


Variolw  Vaccince  :  Edward  Jenner. 


55 


it  produced  a  perfect  pustule  without  any  deviation  from  the  common  appearance  ;  hut  in 
the  other  three  the  progress  of  the  inflammation  was  exactly  similar  to  the  instance  which 
afforded  the  virus  for  their  inoculation  ;  there  was  a  creeping  scab  of  a  loose  texture, 
and  subsequently  the  formation  of  limpid  fluid  at  its  edges.  As  these  people  were  all 
employed  in  laborious  exercises,  it  is  possible  that  these  annomalous  appearances  might 
owe  their  origin  to  the  friction  of  the  clothes  on  the  newly  inflamed  part  of  the  arm.  I 
have  not  yet  had  an  opportunity  of  exposing  them  to  small-pox. 

In  the  early  part  of  this  inquiry  I  felt  far  more  anxious  respecting  the  inflammation  of 
the  inoculated  arm  than  at  present,  yet  that  this  affection  will  go  on  to  a  greater  extent 
than  could  be  wished,  is  a  circumstance  sometimes  to  be  expected.  As  this  can  be  checked, 
or  even  entirely  subdued  by  very  simple  means,  I  see  no  reason  why  the  patient  should 
feel  an  uneasy  hour,  because  an  application  may  not  be  absolutely  necessary.  About  the 
tenth  or  eleventh  day,  if  the  pustule  has  proceeded  regularly,  the  appearance  of  the  arm 
will  almost  to  a  certainty  indicate  whether  this  is  to  be  expected  or  not.  Should  it 
happen,  nothing  more  need  be  done  chan  to  apply  a  single  drop  of  the  aqua  l-ythargyr 
acetati*  upon  the  pustule,  and  having  suffered  it  to  remain  two  or  three  minutes,  to  cover 
the  efflorescence  surrounding  the  pustule  with  a  piece  of  linen  dipped  in  the  aqua 
Ithyargyr  compos. t  The  former  may  be  repeated  twice  or  thrice  during  the  day ;  the 
latter  as  often  as  it  may  feel  agreeable  to  the  patient. 

When  the  scab  is  prematurely  rubbed  off  (a  circumstance  not  unfrequent  among 
children  and  working  people),  the  application  of  a  little  aqua  lythargyri  acet.  to  the  part, 
immediately  coagulates  the  surface  which  supplies  its  place,  and  prevents  a  sore. 

In  my  former  Treatises  on  this  subject,  I  have  remarked  that  the  human  constitution 
frequently  retains  its  susceptibility  of  the  small-pox  contagion  (both  from  effluvia  and 
contact)  after  previously  feeling  its  influence.  In  further  corroboration  of  this  declara¬ 
tion,  many  facts  have  been  communicated  to  me  by  various  correspondents.  I  shall 
select  one  of  them. 

“  Dear  Sir — Society  at  large  must  I  think  feel  much  indebted  to  you  for  your  Inquiries 
and  Observations  on  the  Nature  and  Effects  of  the  Variolse  Vaccinse,  etc.,  etc.  As  I  con¬ 
ceive  what  I  am  now  about  to  communicate  to  be  of  some  importance,  I  imagine  it  can¬ 
not  be  uninteresting  to  you,  especially  as  it  will  serve  to  corroborate  your  assertion  of 
the  susceptibility  of  the  human  system  of  the  variolous  contagion,  although  it  has  pre¬ 
viously  been  made  sensible  of  its  action.  In  November,  1793,  I  was  desired  to  inoculate 
a  person  with  the  small-pox.  I  took  the  variolous  matter  from  a  child  under  the  disease 
in  the  natural  way,  who  had  a  large  burden  of  distinct  pustules.  The  mother  of  the 
child  being  desirous  of  seeing  my  method  of  communicating  the  disease  by  inoculation, 
after  having  opened  a  pustule,  I  introduced  the  point  of  my  lancet  in  the  usual  way  on 
the  back  part  of  my  own  hand,  and  thought  no  more  of  it  until  I  felt  a  sensation  in  the 
part,  which  reminded  me  of  the  transaction.  This  happened  upon  the  third  day;  on  the 
fourth  there  were  all  the  appearances  common  to  inoculation,  at  Avhich  I  was  not  at  all  sur¬ 
prised;  nor  did  I  feel  myself  uneasy,  upon  perceiving  the  inflammation  continue  to  increase 
to  the  sixth  and  seventh  day,  accompanied  with  a  small  quantity  of  fluid,  repeated  ex¬ 
periments  having  taught  me  it  might  happen  so  with  persons  who  had  undergone  the 
disease,  and  yet  would  escape  any  constitutional  affectiou  ;  but  I  was  not  so  fortunate  ; 
for  on  the  eighth  day  I  was  seized  with  all  the  symptons  of  the  eruptive  fever,  but  in  a 
much  more  violent  degree  than  when  I  was  before  inoculated,  which  was  about  eighteen 
years  previous  to  this,  when  I  had  a  considerable  number  of  pustules.  I  must  confess  I 
was  now  greatly  alarmed,  although  I  had  been  much  engaged  in  the  small-pox,  having 
at  different  times  inoculated  not  less  than  two  thousand  persons.  I  was  convinced  my 
present  indisposition  proceeded  from  the  insertion  of  the  variolous  matter,  and,  there¬ 
fore,  anxiously  looked  for  an  eruption.  On  the  tenth  day  I  felt  a  very  unpleasant  sensa¬ 
tion  of  stiffness,  and  heat  on  each  side  of  my  face  near  my  ear,  and  the  fever  began  to 
decline.  The  affection  in  my  face  soon  terminated  in  three  or  four  pustules  attended 
with  inflammation,  but  which  did  not  maturate,  and  I  was  presently  well. 

“I  remain,  dear  sir,  etc., 

‘‘THOMAS  MILES.” 

This  Inquiry  is  not  now  so  much  in  its  infancy  as  to  restrain  me  from  speaking  more  posi¬ 
tively  than  formerly  on  the  important  point  of  scrolula,  as  couneeted  with  the  small-pox. 

Every  practitioner  in  medicine,  who  has  extensively  inoculated  with  the  small-pox,  or 
has  attended  many  of  those  who  have  had  the  distemper  in  the  natural  way,  must  ac¬ 
knowledge  that  he  has  frequently  seen  scrofulous  affections,  in  some  form  or  another, 
sometimes  rather  quickly  showing  themselves  after  the  recovery  of  the  patients.  Con¬ 
ceiving  this  fact  to  be  admitted,  as  I  presume  it  must  be  by  all  who  have  carefully  at¬ 
tended  to  the  subject,  may  I  noc  ask  whether  it  does  not  appear  probable  that  the  gen- 

*Extract  of  Saturn. 

tGoulard  water.  For  further  information  on  this  subject  see  the  first  treatise  on  the  Yar.  Vac.,  Dr.  Mar 
shall’s  letters,  etc. 


56 


Variolce  Vaccince  :  Edward  Jenner. 


eral  introduction  of  the  small-pox  into  Europe  has  not  been  among  the  most  conducive 
means  in  exciting  that  formidable  foe  to  health?  Having  attentively  watched  the  effects 
of  the  cow-pox  in  this  respect,  I  am  happy  in  beiug  able  to  declare,  that  the  disease  does 
not  appear  to  have  the  least  tendency  to  produce  this  destructive  malady. 

The  scepticism  that  appeared  even  among  the  most  enlightened  of  medical  men,  when 
my  sentiments  on  the  important  subject  of  the  cow-pox  were  first  promulgated,  was 
highly  laudable.  To  have  admitted  the  truth  of  a  doctrine,  at  once  so  novel  and  so  un¬ 
like  anything  that  had  ever  appeared  in  the  annals  of  medicine,  without  the  test  of  the 
most  rigid  scrutiny  would  have  bordered  upon  temerity;  but  now,  when  that  scrutiny 
has  taken  place,  not  only  among  ourselves,  but  in  the  first  professional  circles  in  Europe, 
and  when  it  has  been  uniformly  found  in  such  abundant  instances,  that  the  human  frame, 
when  once  it  has  felt  the  influence  of  the  genuine  cow-pox  in  the  way  that  has  been  de¬ 
scribed,  is  never  afterwards,  at  any  period  of  its  existence,  assailable  by  the  small-pox, 
may  I  not  with  perfect  confidence  congratulate  my  country  and  society  at  large  on  their 
beholding,  in  the  mild  form  of  the  cow-pox,  an  antidote  that  is  capable  of  extirpating 
from  the  earth  a  disease  which  is  every  hour  devouring  its  victims;  a  disease  that  has 
ever  been  considered  as  the  severest  scourge  of  the  human  race ! 

[  FINIS.  ] 


DR.  JENNER’S  ACCOUNT 


OF  THE 

ORIGIN  OF  THE  VACCINE  INOCULATION. 


“The  most  important  discoveries,  when  familiarized  to  the  mind,  are 
contemplated  with  indifference.  Who  now  wonders  at  the  discovery  of 
America,  or  the  circulation  of  the  blood?  There  is,  however,  a  period  be¬ 
tween  the  conception  of  a  discovery  and  its  mature  birth,  fraught  with  more 
pangs  than  war  or  women  know  :  and  there  is  no  light  in  which  the  human 
mind  can  be  viewed  more  interesting  than  during  this  anxious  period. 
Whenever,  therefore,  the  author  of  any  greatly  useful  invention  details  the 
progress  of  his  own  mind  during  the  completion  of  his  plan,  the  history  is 
perused  with  avidity.  On  these  grounds  we  conclude  that  our  readers 
will  be  much  gratified  by  the  following  narrative 

“X  am  induced  to  give  the  following  concise  history  of  the  origin  of  vaccine 
inoculation,  from  my  f  requently  observing  that  those  who  only  consider  the  sub¬ 
ject  cursorily ,  confound  the  casual  cow-pox  with  the  disease  when  excited  by 
inoculation.  Edward  Jenner. 

“My  inquiry  into  the  nature  of  the  cow-pox  commenced  upwards  of 
twenty-five  years  ago.  My  attention  to  this  singular  disease  was  first 
excited  by  observing  that,  among  those  whom,  in  the  country,  I  was  fre¬ 
quently  called  upon  to  inoculate,  many  resisted  every  effort  to  give  them 
small-pox.  These  patients,  I  found,  had  undergone  a  disease  they  called 
the  cow-pox,  contracted  by  milking  cows  affected  with  a  peculiar  eruption 
on  their  teats.  On  inquiry,  it  appeared  that  it  had  been  known  among  the 
dairies  time  immemorial,  and  that  a  vague  opinion  prevailed  of  the  small¬ 
pox.  This  opinion  I  found  was,  comparatively,  new  among  them ;  for  all 
the  older  farmers  declared  they  had  no  such  idea  in  their  early  days — a 
circumstance  that  seemed  easily  to  be  accounted  for,  from  my  knowing 
that  the  common  people  were  very  rarety  inoculated  for  the  small  pox,  till 
that  practice  was  rendered  general  by  the  improved  method  introduced  by 
the  Suttons ;  so  that  the  working  people  in  the  dairies  were  seldom  put  to 
the  test  of  the  preventive  powers  ot  the  cow-pox. 

“In  the  course  of  the  investigation  of  this  subject,  which,  like  all  others 
of  a  complex  and  intricate  nature,  presented  many  difficulties,  I  found 
that  some  of  those  who  seemed  to  have  undergone  the  cow-pox ,  nevertheless, 
on  inoculation  with  the  small-pox,  felt  its  influence  just  the  same  as  if  no 
disease  had  been  communicated  to  them  from  the  cow.  This  occurrence 
led  me  to  inquire  among  the  medical  practitioners  in  the  country  around 
me,  who  all  agreed  in  this  sentiment,  that  the  cow-pox  was  not  to  be  relied 
upon  as  a  certain  preventive  of  the  small-pox.  This  for  a  while  damped, 
but  did  not  extinguish  my  ardor  5  for,  as  I  proceeded,  I  had  the  satisfac¬ 
tion  to  learn  that  the  cow  was  subject  to  some  varieties  of  spontaneous 
eruptions  upon  her  teats :  that  they  were  all  capable  of  communicating 
sores  to  the  hands  of  the  milkers;  and  that  whatever  sore  was  derived 
from  the  animal,  was  called  in  the  dairy  the  cow-pox.  Thus  I  surmounted 
a  great  obstacle,  and,  in  consequence,  was  led  to  form  a  distinction  be- 


58 


Dr.  Jenner  on  the  Origin  of  Vaccine  Inoculation, 


tween  these  diseases,  one  of  which  only  I  have  denominated  the  true ,  the 
others  the  spurious  cow-pox,  as  they  possess  no  specific  power  over  the 
constitution.  This  impediment  to  my  progress  was  not  long  removed,  be¬ 
fore  another,  of  far  greater  magnitude  in  its  appearance,  started  up.  There 
were  not  wanting  instances  to  prove,  that  when  the  true  cow-pox  broke 
out  among  the  cattle  at  a  dairy,  a  person  who  had  milked  an  infected 
animal,  and  had  thereby  apparently  gone  through  the  disease  in  common 
with  others,  was  liable  to  receive  the  small-pox  afterwards.  This,  like  the 
former  obstacle,  gave  a  painful  check  to  my  fond  and  aspiring  hopes ;  but, 
reflecting  that  the  operations  of  nature  are  generally  uniform,  and  that  it 
was  not  probable  the  human  constitution  (having  undergone  the  cow-pox) 
should  in  some  instances  be  perfectly  shielded  from  the  small-pox,  and  in 
many  others  remain  unprotected,  I  resumed  my  labors  with  redoubled 
ardor.  The  results  was  fortunate ;  for  I  now  discovered  that  the  virus  of 
cow-pox  was  liable  to  undergo  progressive  changes,  from  the  same  causes 
precisely  as  that  of  small-pox;  and  that,  when  it  was  applied  to  the  human 
skin  in  its -degenerated  state,  it  would  produce  the  ulcerative  effects  in  as 
great  a  degree  as  when  it  was  not  decomposed,  and  sometimes  far  greater ; 
but  having  lost  its  specific  properties  it  was  incapable  of  producing  that 
change  upon  the  human  frame  which  is  requisite  to  render  it  unsusceptible  of 
the  variolous  contagion;  so  that  it  became  evident  a  person  might  milk  a  cow 
one  day,  and  having  caught  the  disease,  be  for  ever  secure;  while  another 
person,  milking  the  same  cow  the  next  day,  might  feel  the  influence  of  the 
virus  in  such  a  way  as  to  produce  a  sore  or  sores,  and,  in  consequence  of  this, 
might  experience  an  indisposition  to  a  considerable  extent ;  yet,  as  has 
been  observed,  the  specific  quality  being  lost,  the  constitution  would  receive 
no  peculiar  impression. 

“Here  the  close  analogy  between  the  virus  of  small-pox  and  of  cow-pox 
becomes  remarkably  conspicuous ;  since  the  former,  when  taken  from  a 
recent  pustule,  and  immediately  used,  gives  the  perfect  small-pox  to  the 
person  on  whom  it  is  inoculated ;  but,  when  taken  in  a  far  advanced  stage 
of  the  disease,  or  when  (although  taken  early),  previously  to  its  insertion, 
it  be  exposed  to  such  agents  as,  according  to  the  established  laws  of 
nature,  cause  its  decomposition,  it  can  no  longer  be  relied  on  as  effectual. 
This  observation  will  fully  explain  the  source  of  those  errors  which  have 
been  committed  by  many  inoculators  of  the  cow-pox.  Conceiving  the 
whole  process  to  be  so  extremely  simple  as  not  to  admit  of  a  mistake,  they 
have  been  heedless  about  the  state  of  the  vaccine  virus ;  and  finding  it 
limpid,  as  part  of  it  will  be,  even  in  an  advanced  stage  of  the  pustule, 
when  the  greater  portion  has  been  converted  into  a  scab,  they  have  felt  an 
improper  confidence,  and  sometimes  mistaken  a  spurious  pustule,  which 
the  vaccine  fluid  in  this  state  is  capable  of  exciting,  for  that  which  pos¬ 
sesses  the  perfect  character. 

“During  the  investigation  of  the  casual  cow-pox,  I  was  struck  with 
the  idea  that  it  might  be  practicable  to  propagate  the  disease  by  inoculation, 
after  the  manner  of  the  small-pox,  first  from  the  cow,  and,  finally,  from 
one  human  being  to  another.  I  anxiously  waited  some  time  for  an  oppor¬ 
tunity  of  putting  this  theory  to  the  test.  At  length  the  period  arrived. 
The  first  experiment  was  made  upon  a  lad  of  the  name  of  Phipps,  in  whose 
arm  a  little  vaccine  virus  was  inserted,  taken  from  the  hand  of  a  young 
woman  who  had  been  accidentally  infected  by  a  cow.  Notwithstanding 
the  resemblance  which  the  pustule,  thus  excited  on  the  boy’s  arm,  bore  to 
Variolous  inoculation,  yet,  as  the  indisposition  attending  it  was  barely 
perceptible,  I  could  scarcely  persuade  myself  the  patient  was  secure  from 


Dr.  Jennets  Instructions  for  Vaccine  Inoculation. 


59 


the  small-pox.  However,  on  his  being  inoculated  some  months  afterwards, 
it  proved  that  he  was  secure.  This  case  inspired  me  with  confidence  ;  and 
as  soon  as  I  could  again  furnish  myself  with  virus  from  the  cow,  I  made 
an  arrangement  for  a  series  of  inoculations.  A  number  of  children  were 
inoculated  in  succession,  one  from  the  other.;  and,  after  several  months 
had  elapsed,  they  were  exposed  to  the  infection  of  the  small  pox — some  by 
inoculation,  others  by  variolous  effluvia.,  and  some  in  both  ways ;  but  they 
all  resisted  it.  The  result  of  these  trials  gradually  led  me  into  a  wider 
field  of  experiment,  which  I  went  over  not  only  with  great  attention,  but 
with  painful  solicitude.  This  became  universally  known  through  a  treatise 
published  in  June,  1798.  The  result  of  my  further  experience  was  also 
brought  forward  in  subsequent  publications,  in  the  two  succeeding  years, 
1799  and  1800.  The  distrust  and  scepticism  which  naturally  arose  in  the 
minds  of  medical  men,  on  my  first  announcing  so  unexpected  a  discovery, 
has  now  nearly  disappeared.  Many  hundreds  of  them,  from  actual  ex¬ 
perience,  have  given  their  attestations  that  the  inoculated  cow-pox  proves 
a  perfect  security  against  the  small-pox ;  and  I  shall  probably  be  within 
compass  if  I  say  thousands  are  ready  to  follow  their  example ;  for  the 
scope  that  this  inoculation  has  now  taken  is  immense.  A11  hundred  thou¬ 
sand  persons,  upon  the  smallest  computation,  have  been  inoculated  in  these 
realms.  The  numbers  who  have  partaken  of  its  benefits  throughout  Eu¬ 
rope,  and  other  parts  of  the  globe,  are  incalculable;  and  it  now  becomes 
too  manifest  to  admit  of  controversy,  that  the  annihilation  of  the  small¬ 
pox,  the  most  dreadful  scourge  of  the  human  species,  must  be  the  final 
result  of  this  practice.” — [The  Medical  Depository,  vol.  v.,  p.  239,  Neic  YorTc, 
1802. J 


DR.  JENIFER’S  INSTRUCTIONS  FOR  VACCINE  INOCULATION. 

Let  the  vaccine  fluid  be  taken  for  the  purpose  of  inoculation  from  a  pus¬ 
tule  that  is  making  its  progress  regularly,  and  which  possesses  the  true 
vaccine  character,  on  any  day  from  the  fifth  to  the  eighth,  or  even  a  day  or 
two  later,  provided  the  efflorescence  be  not  formed  around  it.  When  the 
efflorescence  is  formed,  it  is  always  most  prudent  to  desist  from  taking  any 
more  of  the  virus  from  the  pustule. 

To  obtain  the  virus,  let  the  edges  of  the  pustule  be  gently  punctured 
with  a  lancet  in  several  points.  It  will  gradually  ooze  out,  and  should  be 
inserted  upon  the  arm,  about  midway  between  the  shoulder  and  the  elbow, 
either  by  means  of  a  very  slight  scratch,  not  exceeding  the  eighth  part  of 
an  inch,  or  a  very  small  oblique  puncture. 

A  little  red  spot  will  appear  on  the  third  day,  if  the  operation  succeed, 
which,  011  the  fourth  or  fifth,  becomes  perceptibly  vesicated.  It  goes  on 
increasing  till  the  tenth  day,  when  it  is  generally  surrounded  by  a  rose  co¬ 
lored  efflorescence,  which  remains  nearly  stationary  for  a  day  or  two. 
The  efflorescence  then  fades  away,  and  the  pustule  is  gradually  converted 
into  a  hard  glossy  scab,  of  a  dark  mahogany  color.  These  progressive 
stages  of  the  pustule  are  commonly  completed  in  sixteen  or  seventeen  days. 

A  single  pustule  is  sufficient  to  secure  the  constitution  from  the  small¬ 
pox,  but  as  we  are  not  always  certain  the  puncture  may  take  effect,  it  will 
be  prudent  to  inoculate  in  both  arms,  or  to  make  two  punctures  in  the 
same  arm,  about  an  inch  and  an  half  asunder,  except  in  very  early  in¬ 
fancy,  when  there  is  a  great  susceptibility  of  local  irritation. 


60 


Dr.  Jennets  Instructions  for  Vaccine  Inoculation. 


If  the  efflorescence  surrounding  the  pustule  should  be  extensive,  and 
occasion  much  local  heat  upon  the  arm,  it  may  be  cooled  by  the  repeated 
application  of  pieces  of  folded  linen  dipped  in  cold  water,  or  still  more 
expeditiously  by  a  strong  solution  of  the  aqua  lythargyri  acetati*  in  water,, 
an  ounce,  for  example,  of  the  former  in  five  or  six  of  the  latter. 

If  the  scab  should  atan;v  time  be  prematurely  rubbed  off,  rhe  party  may 
be  occasionally  touched  with  undiluted  aqua  lythargyri  acetati. 

Vaccine  virus,  taken  from  a  pustule,  and  inserted  immediately  in  its  lluid 
state,  is  preferable  to  that  which  has  been  previously  dried ;  but  as  it  is 
not  always  practicable  to  obtain  it  in  this  state,  we  are  compelled  to  seek 
for  some  mode  of  preserving  it.  Various  means  have  been  suggested,  but 
from  the  test  of  long  experience  it  may  be  asserted,  that  preserving  it  be¬ 
tween  two  plates  of  glass  is  the  most  eligible.  Let  a  piece  of  common 
window  glass  be  cut  into  squares  of  about  an  inch  each,  so  that  they  shall 
lie  smooth  when  placed  upon  each  other.  Let  the  collected  vaccine  fluid 
be  confined  to  a  small  spot  (about  the  size  of  a  split  pea)  upon  the  centre 
of  one  of  these  glasses ;  which  should  be  suffered  to  dry  in  the  common 
heat  of  the  atmosphere,  without  exposure  to  the  heat  of  fire  or  the  sun. 
When  dry,  it  should  be  immediately  secured  by  placing  over  it  the  other 
piece  of  glass.  ISTothing  more  is  necessary  for  its  preservation  than  wrap¬ 
ping  it  in  clean  writing  paper. 

The  virus  thus  preserved,  when  wanted  for  the  purpose  of  inoculation, 
may  easily  be  restored  to  its  fluid  state  by  dissolving  it  in  a  small  portion 
of  cold  water,  taken  upon  the  point  of  a  lancet.  It  may  be  used  in  the 
same  manner  as  when  just  taken  from  a  pustule. 

The  vaccine  fluid  is  liable,  from  causes  apparently  trifling,  to  undergo  a 
decomposition.  In  this  state  it  sometimes  produces  what  has  been  denomi¬ 
nated  the  spurious  pustule  ;  that  is,  a  pustule,  or  an  appearance  on  the 
arm  not  possessing  the  characteristic  marks  of  the  genuine  pustule. 
Anomalies,  assuming  different  forms,  may  be  excited,  according  to  the 
qualities  of  the  virus  applied,  or  the  state  of  the  person  inoculated ;  but  by 
far  the  most  frequent  variety,  or  deviation  from  the  perfect  pustule,  is  that 
which  arrives  at  maturity,  and  finishes  its  progress  much  within  the  time 
limited  by  the  true.  Its  commencement  is  marked  by  a  troublesome  itch¬ 
ing  ;  and  it  throws  out  a  premature  efflorescence,  sometimes  extensive,  but 
seldom  circumscribed,  or  of  so  vivid  a  tint  as  that  which  surrounds  the 
pustule  completely  organized ;  and  (which  is  more  characteristic  of  its  de¬ 
generacy  than  the  other  symptoms)  it  appears  more  like  a  common  fester¬ 
ing  produced  by  a  thorn,  or  any  other  small  extraneous  body  sticking  in 
the  skin,  than  a  pustule  excited  by  the  vaccine  virus.  It  is  generally  of  a 
straw  color ,  and  when  punctured,  instead  of  that  colorless,  transparent 
fluid  of  the  perfect  pustule,  its  contents  are  found  to  be  opaque.  That  de¬ 
viation  from  the  common  character  of  the  pustule,  arising  from  vaccine 
virus  which  has  been  previously  exposed  to  a  degree  of  heat  capable  of 
decomposing  it,  is  very  different.  In  this  instance  it  begins  with  a  creep¬ 
ing  scab,  of  a  pale  brown  or  amber  color,  making  a  long  and  slow  progress, 
and  sometimes  going  through  its  course  without  any  perceptible  efflor¬ 
escence.  Its  edges  are  commonly  elevated,  and  afford  on  being  punctured, 
a  liquid  fluid. 

A  little  practice  in  vaccine  inoculation,  attentively  conducted,  impresses 
on  the  mind  the  perfect  character  of  the  vaccine  pustule therefore,  when 
a  deviation  arises,  of  whatever  kind  it  may  be,  common  prudence  points 
out  the  necessity  of  reinoculation ;  first  with  vaccine  virus  of  the  most 

*Goulard’a  Extract  of  Saturn. 


Dr.  Tenners 1  Instructions  for  Vaccine  Inoculation. 


61 


-active  kind ;  and,  secondly,  should  this  be  ineffectual,  with  variolous  virus. 
But  if  the  constitution  shows  an  insusceptibility  of  one,  it  commonly  does 
of  the  other. 

When  any  constitutional  symptoms  occur  in  inoculated  cow-pox,  they  are 
commonly  first  perceptible  (especially  in  children)  on  the  fourth  or 'fifth 
day.  They  appear  again,  and  sometimes  in  adults,  not  unlike  a  mild  at¬ 
tack  from  inoculated  small-pox,  on  the  eighth,  ninth,  or  tenth  day.  The 
-former  arise  from  the  general  effects  of  the  virus  on  the  habit,  the  latter 
from  the  irritation  of  the  pustule. 

If  the  effluvia  of  the  small-pox  have  been  received  into  the  habit,  pre¬ 
viously  to  the  inoculation  of  the  vaccine  virus,  the  vaccine  inoculation  will 
not  always  be  found  to  stop  its  progress,  although  the  pustule  may  make  its 
advances  without  interruption. 

The  lancet  used  for  the  inoculation  should  always  be  perfectly  clean. 
After  each  puncture,  it  is  proper  to  dip  it  into  water,  and  wipe  it  dry. 

The  preservation  of  vaccine  virus  upon  a  lancet  beyond  the  period  of  a 
Tew  days,  should  never  be  attempted ;  as  it  is  apt  to  produce  rust,  which 
will  decompose  it. — The  Medical  Repository ,  Vol.  v  ;  Now  York  1802 ;  paqe 

483. 

*  EDWARD  JENNER. 


Shortly  after  the  discovery  of  Dr.  Jenner  had  attracted  public  attention, 
Dr.  George  Pearson  rendered  service  to  the  cause  of  vaccination  by  es¬ 
tablishing  an  extensive  correspondence  with  medical  men  in  different  parts 
of  England,  by  which  he  was  enabled  to  prove  that  cow-pox  was  much 
more  widely  epizootic  than  had  been  at  first  believed )  and  that  all  the 
•local  traditions  fully  confirmed  Dr.  JennePs  positions. 

The  early  letters  of  Dr.  Pearson  indicated  not  less  ardor  in  behalf  of 
vaccination  than  respect  and  admiration  for  its  author. 

Dr.  Jenner  amply  repaid  the  good  will  of  his  correspondent  by  the 
most  unreserved  communication  of  all  the  knowledge  which  he  possessed. 

On  the  eighth  of  November,  1798,  and  just  on  the  eve  of  the  publication 
■of  his  pamphlet,  Dr.  George  Pearson  wrote  a  letter  to  Dr.  Jenner  which, 
among’ other  matter,  contained  the  following  expression :  “Your  name  will 
live  in  the  memory  of  mankind  as  long  as  men  possess  gratitude  for 
services  and  respect  for  benefactors  ;  and  if  I  can  get  matter  I  am  much 
mistaken,  if  I  do  not  make  your  live  for  ever.” 

About  the  middle  of  November,  1798,  Dr.  Pearson  published  his  inquiry 
concerning  the  history  of  the  cow-pox,  and  thus  announced  its  appearance 
to  Dr.  Jenner. 


DR.  PEARSON  TO  DR.  JENNER. 

My  Dear  Sir — Unexpectedly  my  pamphlet  made  its  public  appearance  a  day  or  two 
ago.  I  am  sorry  to  trouble  you  to  say  by  wbat  conveyance  I  can  send  you  a  copy,  and 
to  wbat  place?  If  you  have  any  commissions  to  execute  in  London,  you  may  as  well 
have  a  parcel  made  up,  and  I  will  see  it,  forwarded.  I  observe  several  errors  since  print¬ 
ing,  partly  mine  and  partly  those  of  the  printer  ;  hut  I  know  other  authors  discover 
similar  errors,  and  that  readers  do  not  perceive  them. 

You  can  not  imagine  how  fastidious  the  people  are  with  regard  to  this  business  of  the 
cow-pox  ;  one  says  it  is  very  filthy  and  nasty  to  derive  it  from  the  sore  heel  of  horses  ; 
another,  O,  my  God,  we  shall  introduce  the  diseases  of  animals  among  us,  and  we  have 
too  many  already  of  our  own  ! 


62 


Dr.  Pearson"1 s  Letter  to  Dr.  Jenner. 


A  third  sapient  set  say  it  is  a  strange,  odd  kind  of  business,  and  they  know  not  what 
to  think  of  it.  All  this  I  hear  very  quietly,  and  rocollect  that  a  still  more  unfavorable  re¬ 
ception  was  experienced  by  the  inoculation  of  the  small-pox. 

I  wish  you  could  secure  for  me  matter  for  inoculation,  because,  depend  upon  it,  a 
thousand  inaccurate,  but  imposing  cases,  will  be  published  against  the  specific  nature 
of  the  disease  by  persons  who  want  to  send  their  uames  abroad  about  any  thing,  and 
who  will  think  yourself  and  me  fair  game.  By  way  of  Le  defendendo  we  must  inoculate, 
I  have  thought  it  right  to  publish  the  evidence  as  sent  to  me,  and  also  my  own  reasoning,, 
because  I  know  you  are  too  good  a  philosopher  to  be  offended  at  the  investigation  of 
truth,  although  the  conclusions  may  be  different  from  your  own.  I  think,  too,  your 
principal  facts  will  be  the  better  established  than  if  it  had  happened  that  I  had  uni¬ 
formly  acceded  to  all  your  doctrine. 

I  am,  with  Mrs.  P’s  best  compliments  to  Mrs.  Jenner  and  yourself, 

Your  obedient  servant,  G.  PEARSON, 

Leicester  Square,  November  13,  1798. 

During  my  visit  to  Europe,  in  1870,  I  succeeded,  after  a  careful  search, 
in  obtaining  in  London,  a  single  copy  of  the  work  of  Dr.  George  Pearson, 
and  also  of  the  work  of  Dr.  Woodville,  and  we  conceive  it  of  importance 
to  the  medical  profession  of  America,  that  they  should  be  reproduced  in 
connection  with  the  works  of  Dr.  Jenner,  which  are  so  fully  sustained  by 
the  facts  illustrating  the  history  of  the  cow-pox. 


AN  INQUIRY 


CONCERNING 

THE  HISTOHT 

OF  THE 


c  o  w  -  if*  o  x:  3 

PRINCIPALLY  WITH  A  VIEW  TO 


SHFEHSE8E  AND 


THE 


GEORGE  PEARSON,  M:  D.  F.  R.  S. 


PHYSICIAN  TO  ST.  GEORGE’S  HOSPITAL  ;  OF  THE  COLLEGE  OF  PHYSICIANS, 


Feliciores  Inserit. — Hot. 


LONDON : 

Printed  for  J.  Johnson,  No.  72,  St.  Paul’s  Cliuroli  Yard. 

1798. 


. 


. 


TO  SIR  GEORGE  BAKER, 


Bart. 


Physic  ian  to  their  Majesties,  F.  R.  S.  &c.,  &c. : 

Whose  medical  writing  and  pre-eminent  learning  reflect  honor  on  the  pro¬ 
fession  of  physic  : 

This  work  is  inscribed  as  tin  acknowledgment  for  promoting  the  present 
inquiry,  and  as  a  public  testimony  of  personal  regard, 

By  his  ever  truly  faithful  and  obedient  servant, 

GEOliGE  PEARSON. 

Leicester  Square,  November,  1 70S. 


INQUIRIES  CONCERNING  THE  COW-POX. 


The  curiosityof  the  public  has  been  lately  gratified  by  the  publication  of  the  long-ex¬ 
pected  treatise  of  Hr.  Jenner,*  on  an  epizootic  disease,  commonly  known  to  dairy  farmers 
by  the  name  of  the  cow-pox.  This  distemper  of  cows  has  been  noticed,  time  imme¬ 
morial,  in  many  provincial  situations,  where  it  has  been  also  observed  to  have  been  com¬ 
municated  from  these  diseased  animals  to  the  persons  who  milk  them.  In  the  work  just 
spoken  of  several  facts  are  related,  which  seem  to  let  new  light  into  the  nature  of  the 
animal  economy,  and  to  exhibit  a  near  prospect  of  most  important  benefits  in  the  prac¬ 
tice  of  physic.  But  as  some  of  these  facts  do  not  accord,  nay,  as  they  are  at  variance  in 
essential  particulars  with  those  to  which  they  are  nearest  related,  the  truth  of  them  is 
rather  invalidated  than  confirmed  by  analogy;  hence  the  testimony  of  a  single  observer, 
however  experienced,  aud  worthy  to  be  credited,  it  is  apprehended  is  insufficient  for 
procuring  such  facts  a  general  acceptance.  But  granting  that  the  facts  should  be  gen¬ 
erally  admitted,  without  hesitation,  to  be  true  in  the  instances,  which  have  fallen  under 
the  notice  of  the  wTriter  of  the  above  work,  the  more  judicious  part  of  the  medical  pro 
fession  will  require  the  observations  to  be  derived  from  much  more  extensive  and  varied 
experience,  in  order  to  appreciate,  justly,  the  value  of  the  practical  conclusions.  Hence 
there  appears  but  little  likelihood  of  improvements  in  practice  being  made,  unless  the 
subject  be  investigated  by  many  inquirers,  and  the  attention  of  the  public  at  large  be 
kept  excited.  I  do  not  think  that  it  is  necessary  for  me  to  explain  the  various  modes, 
and  point  out  the  situations  in  which  inquiries  may  be  prosecuted.  These  I  suppose  will 
without  difficulty,  be  understood  by  perusing  Dr.  Jenuer’s  treatise.  I  hope  I  shall  not 
be  considered  as  assuming  too  much  in  recommending,  not  only  those  of  the  profession 
of  physic,  but  dairy  farmers,  and  others  who  reside  in  the  country,  to  collect  the  facts 
on  the  subject,  which  have  hitherto  fallen  under  notice,  only  in  a  casual  way.  From 
such  a  procedure,  it  is  reasonable  to  calculate  that  the  acquisition  of  established  truths 
will  be  greatly  accelerated,  or  error  will  be  exploded. 

Agreeably  to  the  preceding  representation,  I  go  forward  to  examine  the  evidence  of  the 
principal  facts,  asserted  in  the  publication  on  the  cow-pox  ;  and  to  state  what  farther 
evidence  I  have  derived  from  my  own  experience,  and  from  the  communications  of  a 
number  of  professional  gentlemen,  of  unsuspected  veracity,  and  undoubted  accuracy. 

Perhaps  it  may  be  right  to  declare,  that  I  entertain  not  the  most  distant  expectation  of 
participating  the  smallest  share  of  honor,  on  the  score  of  discovery  of  facts.  The 
honor  on  this  account,  by  the  justest  title,  belongs  exclusively  to  Dr.  Jenner;  and  I 
would  not  pluck  a  sprig  of  laurel  from  the  wreath  that  decorates  his  brow. 

This  declaration  I  can  prove  to  demonstration!  is  utterly  superfluous  for  this  gentleman 
himself,  but  I  am  not  confident  that  it  is  altogether  without  use,  to  exempt  me  from  the 
suspicious  which  certain  members  of  the  profession  (with  whom  I  will  have  no  fellow¬ 
ship)  would  be  anxious  to  excite. 

The  first  fact  in  order  which  I  shall  examine,  may  be  stated  in  the  following  terms: 

1.  Persons  who  have  undergone  the  specific  fever  arid  local  disease,  occasioned  bg  the  cow-pox 
infection,  communicated  in  the  accidental  wag,  ( who  had  not  undergone  the  small-pox,)  are 
thereby  rendered  unsusceptible  of  the  small-pox. 

To  establish  this  important  fact,  Dr.  Jenner  has  related  (p.  9  to  261  about  twenty  in¬ 
stances  of  inoculation  of  the  small-pox,  of  persons  who  were  known  to  have  gone  through 
the  cow-pox,  but  not  one  of  them  took  the  small-pox  in  this  way;  nor  by  associating 
afterwards,  with  patients  laboring  under  this  disease.  The  permanency  of  theiuexcita- 
bility  of  the  constitution  to  thesmall-pox,  was  manifested  by  some  of  the  instances  being 
persons  who  had  been  affected  with  the  cow-pox  twenty,  thirty,  forty,  and  even  fifty-three 
years  before.  It  must  not  be  supposed  that  the  fact  is  supported  by  merely  these  twenty  in¬ 
stances  ;  which  were  selected  for  illustiation  ;  for  Dr.  Jenner  having  resided  in  Glouces¬ 
tershire  twenty  years,  in  which  county  the  cow-pox  is  frequently  epizootic,  several 
hundred  instances  must  have  fallen  under  his  own  observation,  or  that  of  his  acquain¬ 
tance,  of  persons  not  taking  the  small-pox,  who  had  gone  through  the  cow-pox.  Dr. 

*  An  Inquiry  into  the  causes  and  effects  of  the  variolas  vaccinse,  etc.,  on  the  cow-pox.  by  Edward  Jenner 
M.  D.  E.  R.  S.  etc,,  4to  London,  1798. 

t  On  showing  to  Dr.  Jenner  the  original  paper  which  I  read,  as  a  lecture  on  the  cow-pox;  and  which 
furnishes  the  principal  materials  of  this  dissertation,  he  seemed  only  anxious  that  I  should  not  think  it 
important  enough  for  publication. 


08 


Cow-Fox;  George  Pearson,  .1/.  I). 


Jenner  appears  to  have  been  occupied  for  a  long  time  in  ascertaining  this  fact.  And  to 
prove  that  he  has  an  extraordinary  claim  to  credit  on  that  account,  I  will  mention  the 
following  occurrence.  When  I  was  in  company  with  the  late  Mr.  John  Hunter,  about 
nine  years  ago,  I  heard  him  communicate  the  information  he  had  received  from  Dr. 
Jenner,  that  in  Gloucestershire  an  infectious  disorder  frequently  prevailed  among  the 
milch  cows,  named  the  cow-pox,  in  which  there  was  an  eruption  on  their  teats— that 
those  who  milked  such  cows  were  liable  to  he  affected  with  pustulous  eruptions  on  their 
hands,  which  were  also  called  the  cow-pox — that  such  persons  as  had  undergone  this 
disease,  could  not  be  infected  by  the  variolous  poison,  and  that  as  no  patient  had  been 
known  to  die  of  the  cow-pox,  the  practice  of  inoculation,  of  the  poison  of  this  disease, 
to  supersede  the  small-pox  might  be  found,  on  experience,  to  be  a  great  improvement  in 
physic. 

I  noted  these  observations,  and  constantly  related  them,  when  on  the  subject  of  the 
small-pox,  in  every  course  of  lectures  which  I  have  given  since  that  time. 

This  fact  has  been  mentioned  in  two  publications :  nameiy,  by  Mr.  Adams,* * * §  in  bis  book 
on  morbid  poison,  etc.,  in  1795  ;  and  by  Dr.  Woodville,  in  his  History  of  Inoculation,  in 
1796.1 

On  conversing  with  Sir  George  Baker,  Bart,  concerning  the  cow-pox,  rendering  people 
unsusceptible  of  the  variolous  disease,  Sir  George  observed,  he  had  been  informed  of  the 
fact,  in  some  papers,  on  the  cow-pox,  communicated  to  him  many  years  ago  ;  but  that  as 
thi  statement  did  not  then  obtain  credit,  it  was  not  published.  After  a  fruitless  search 
for  these  papers,  Sir  George,  whose  zeal  for  the  improvement  of  physic  did  not  forsake 
him  on  this  occasion,  authorized  me  to  write  to  his  relative,  the  Rev.  Herman  Drewe,  of 
Abbotts.  From  Ibis  gentleman,  who  had  availed  himself  of  great  opportunities  of  in¬ 
quiring  into  the  nature  of  the  cow-pox,  when  he  resided  in  Dorsetshire,  I  immediately 
received  answers  in  a  very  polite  letter,  to  all  the  queries  which  I  took  the  liberty  of 
proposing.  With  regard  to  the  fact  under  examination,  the  information  received  from 
this  gentleman  is  in  these  terms  :  “Mr.  Bragged  who  inoculated  my  parish,  rejoiced  at 
having  an  opportunity  of  ascertaining  the  fact.  Three  women  had  had  the  cow-pox, 
he  therefore  charged  them  with  a  superabundance  of  matter,  but  to  no  purpose  ;  all  his 
other  patients,  more  than  fifty,  took  the  infection,  but  the  three  women  were  not  in  the 
least  disordered,  even  though  they  associated  constantly  with  those  who  were  infected. 
Thirteen  similar  instances  I  at  that  time,  in  that  neighborhood  ascertained.”  Mr. 
Drewe  observes,  that  the  disorder  “is  epizootic  in  Devonshire,  Dorsetshire,  and  Somer¬ 
setshire,  and  there  is  no  doubt  that  it  is  to  be  met  with  elsewhere,  under  the  name  of  cow- 
pox,  or  some  other  denomination.  When  I  made  inquiries  about  the  cow-pox 
I  resided  in  Dorsetshire,  and  gained  all  my  information  from  a  Mr.  Downe,  Surgeon, 
of  Bridport,  a  Mr.  Bragge,  Surgeon  of  Axminster,  and  a  Mr.  Barnes,  of  Colyton  (siuce 
dead.)  I  have  not  thought  of  the  matter  since,  and  as  my  letters  on  the  subject  have  es¬ 
caped  Sir  George  Baker’s  search,  so  many  particulars  have  my  recollection.” 

Dr.  Pulteueyll  of  Blandford,  who  did  me  the  honor  to  answer  the  question  which  I 
troubled  him  with,  informs  me  “that  the  disease  is  well  known  in  Hampshire,  Dorset¬ 
shire,  Somersetshire,  and  Devonshire.  That  it  is  not  uncommon  in  Leicestershire,  and 
other  midland  counties,  but  dairy-men  keep  it  a  secret  as  much  as  possible,  as  it  is  dis¬ 
reputable  to  the  cleanliness  of  the  produce.  An  intelligent  and  respectable  inoculator  in 
this  country,  informed  me,  that  of  several  hundreds  whom  he  had  inoculated  for  the 
small-pox,  who  had  previously  had  the  cow  pox,  very  few  took  the  infection  ;  and  such 
as  did  he  had  great  room  to  believe  were  themselves  deceived,  in  regard  to  their  having 
had  the  cow-pox.” 

I  am  deeply  indebted  for  several  letters  on  the  subject,  to  the  Rev.  Henry  Jerome  de 
Salis,  D.  D.§  “I  have  heard,”  says  he,  “a  good  deal  of  the  cow-pox  in  this  country.  I 
have  given  a  copy  of  your  questions  to  Mr.  Heurtley,  and  another  to  Sir  William  Lee, 
and  I  dare  say,  after  a  time  this  country  will  produce  much  information  relative  to  the 
cow-pox.  I  have  found  that  in  this  parish,  (Wing)  this  disorder  raged  in  one  farm,  but 
did  not  get  beyond  it,  three  years  ago.  A  man  who  now  works  with  me,  was  employed 
with  three  others  in  milking  the  cows.  None  but  himself  had  had  the  small-pox,  all 
three  had  the  cow-pox,  but  he  quite  escajied  it.  One  of  these  three  is  now  in  the  parish, 

*  “  The  cow-pox  is  a  disease  well  known  to  the  dairy  farmers  in  Gloucestershire.  ‘What  is  extraor¬ 
dinary,  as  far  as  facts  have  hitherto  been  ascertained,  the  person  who  has  been  infected  is  rendered  insen¬ 
sible  to  the  variolous  posion.”  Adamson  Morbid  Poisons,  8vo.  1795,  p.  156, 

t  “It  has  been  conjectured  that  the  small-pox  might  have  been  derived  from  some  disease  of  brute  ani¬ 
mals  ;  and  if  it  he  true  that  the  mange,  affecting  dogs,  can  communicate  a  species  of  itch  to  man  ;  or,  that 
a  person,  having  received  a  certain  disorder  from  handling  the  seats  of  cows,  is  thereby  rendered  insensible 
to  variolous  infection  ever  afterwards,  as  some  have  asserted  ;  then  indeed  the  conjecture  is  not  improba¬ 
ble  Woodville,  p.  7- 

+  Mr.  Drowe's  Letter,  Abbotts,  July  5,  1798. 

II  Dr.  Pulteney’s  Letter,  Blandford,  July  14,  1798. 

§  Dr.  de  Salis’  Letters,  Wing.  Bucks,  July  20th,  25th  and29th,  1798. 


Cow-Pox ;  George  Pearson ,  M.  P. 


69 


and  I  will  have  him  inoculated  for  the  small-pox.  He  was  ranch  struck  with  the  resem¬ 
blance  of  the  symptoms  to  those  he  had  lately  experienced  in  the  small-pox.  Mr.  Thomas 
Rhodes,  a  respectable  farmer  and  dairy-man  at  Abbots- Asron,  (a  parish  adjoining  to 
this)  had  the  cow-pox  when  he  was  a  boy,  and  was  afterwards  inoculated  for  the  small¬ 
pox,  without  effect.  As  this  is  a  case  quite  in  point,  and  as  I  know  the  man  perfectly 
well,  and  also  know  the  inoeulator,  I  will  have  all  the  particulars  drawn  up  in  the  man¬ 
ner  you  may  direct,  and  authenticated  in  the  course  of  a  few  days.  I  have  the  name  of 
a  servant  of  his  father’s  who  had  the  cow-pox  at  the  same  time  that  he  had  it.  This 
man  lives  in  the  adjoining  parish  of  Soulbury,  and  if  he  has  not  had  the  small-pox 
since,  I  will  have  him  inoculated  after  harvest.” 

In  the  dairy  farm  above  mentioned,  in  which  the  cow-pox  raged  three  years  ago',  it  had 
not  appeared  for  the  preceding  fourteen  or  fifteen  years.  Two  men  were  then  infected, 
ono  of  whom  liyes  now  at  Aylesbury,  and  the  other  at  Bushy.  For  reasons  which  1  will 
hereafter  give  you,  I  shall  inquire  after  the  man  at  Aylesbury.” 

From  Mr.  Downe,*  Surgeon  of  Bridport,  I  have  received  some  important  information. 

“The  cow-pox  is  a  disorder  in  Devonshire  as  well  as  Dorsetshire,  but  it  so  rarely 
occurs,  that  the  sources  of  information  are  very  scanty.  A  few  years  ago,  when  I  inocu¬ 
lated  a  great  number  for  the  small-pox,  I  remarked  that  I  could  not,  by  any  means,  in¬ 
fect  one  or  two  of  them,  and  on  inquiry,  I  was  informed  they  had  previously  been  in¬ 
fected  with  the  cow-pox.  Some  few  families  who  had  been  infected  with  the  cow-pox, 
were  repeatedly  inoculated  with  the  matter  of  the  small-pox,  and  without  effect.  I 
know  that  a  medical  man  m  this  part  of  the  country  was  injured  in  his  practice,  by  a 
prejudice  raised  unjustly,  that  ho  intended  to  substitute  the  cow-pox  for  the  small-pox. 
So  great  an  enemy  to  improvement  are  the  prejudices  of  the  public  in  the  country,  that 
I  think  experiments  of  importance  can  only  be  made  in  hospitals. 

“A  farmer’s!  wife  in  this  neighbourhood,  her  daughter,  and  two  sons,  were  all  em¬ 
ployed  in  milking  the  cows  when  this  disorder  prevailed  among  them.  The  mother  had 
gone  through  the  small-pox  in  the  natural  way,  but  the  others  had  never  had  the  small¬ 
pox.  The  latter,  viz  :  the  two  sons  and  daughter,  were  infected  from  the  cows,  and  the 
mother  continued  to  milk  them  the  whole  time,  without  the  least  inconvenience.  The 
daughter  and  two  sons  had  a  slight  fever,  and  afterwards  eruptions  on  the  hands,  by 
#hich  they  were  much  relieved  of  their  fever.  I  had  this  account  from  one  of  the  parties 
infected,  and  it  may  be  depended  upon. 

About  three  years  since  I  inoculated  between  six  and  seven  hundred,  and  I  recollect 
one  or  two  of  the  number  who  could  not  be  infected.  On  inquiry  I  found  they  had 
previously  had  the  cow-pox.” 

The  Rev.  John  Smith,  of  Wendover,  to  whom  I  owe  many  thanks  for  very  willingly, 
a‘t  my  request,  taking  upon  himself  the  trouble  of  making  inquiries  in  his  neighbor¬ 
hood,  informs  met  that  the  high  land  of  his  parish  does  not  admit  of  dairying  upon  it, 
and  the  dairy  farmers  here  know  nothing  of  the  cow-pox.  But  Mr.  Henderson,  the 
Surgeon  in  the  parish,  whose  practice  takes  him  a  little  into  the  vale,  telis  me,  that  he 
has  met  with  the  disease,  and  that  a  few  years  ago  he  three  times  endeavoured  to  inocu¬ 
late  a  lad,  who  had  been  used  to  milking,  but  could  only  excite  inflammation  upon  the 
arm,  without  any  pustulous  appearance.  And  upon  inquiry,  he  found  the  lad  had  pre¬ 
viously  been  affected  with  the  cow-pox.  Mr.  Woodman,  a  Surgeon  at  Aylesbury,  had 
met  with  the  disease  among  the  cow  boys  in  the  vale.  Mr.  Grey,  a  Surgeon  of  Bucking¬ 
ham,  says'the  disorder  is  common  among  the  milkers  in  his  neighborhood.  He  had  not 
been  led  to  consider,  particularly,  the  effects  of  the  disease,  but  he  remembers  one  boy 
possessed  of  the  idea,  that  he  could  not  take  the  small-pox  by  inoculation,  because  he 
had  had  the  cow-pox,  and  that  he  could  only  excite  redness  upon  the  boy’s  arm.  He 
thinks  he  recollects  cases  of  boys  having  had  the  small-pox,  after  having  had  the  cow- 
pox.  The  disease  is  not  very  notorious,  for  I  passed  some  days  last  week  with  two  intel¬ 
ligent  farmers,  one  of  them  had  kept  seventy  milk  cows  for  many  years  past,  but  knew 
nothing  of  the  cow-pox  among  his  servants.  The  other  knew  as  little." 

Mr.  Giffard,||  Surgeon  of  Gillingham,  near  Shaftsbury,  has  been  so  good  as  to  write  to 
me  on  the  subject  of  the  cow-pox  ;  he  informs  me.  “That  it  is  a  disease  more  known  in 
Dorsetshire  than  in  most  other  counties,”  “I  last  winter,”  says  he,  “inoculated  three 
parishes,  and  some  of  the  subjects  told  me  they  had  had  the  cow-pox,  and  that  they 
should  not  take  the  small-pox  but  I  desired  to  inoculate  them.  I  did  so  two  or  three 
times,  but  without  effect.  Persons  never  take  the  small-pox  after  they  have  had  the 
cow-pox.” 

On  Thursday,  June  14th  last,  happening,  with  Mr.  Lucas,  Apothecary,  to  be  on  pro¬ 
fessional  business  at  Mr.  Wilan’s  farm,  adjoining  to  the  New  Road,  Maybone  ;  which 


*  Mr.  Downe's  Letter,  Bridport,  August  1,  1798. 
t  Mr.  Cowrie's  Second  Letter,  Bridport,  August  25,  1798. 

I  Mr.  Smith’s  Letter,  Vicarage,  Wendover,  August  5,  1798. 
•'ll  Mr.  Giffard’s  Letter,  Gillingham,  August  9.  1798. 


70 


Coic-Pox;  George  Pearson,  M.  7). 


farm  is  appropriated  entirely  for  the  support  of  from  800  to  1000  milk  cows  ;  I  availed 
myself  of  that  opportunity  to  make  inquiry  concerning  the  cow-pox.  I  was  told  it  was 
a  pretty  frequent  disease  among  the  cows  of  that  farm,  especially  in  winter.  That  it 
was  supposed  to  arise  from  sudden  change  from  poor  to  rich  food.  It  was  also  well 
known  to  the  servants,  some  of  whom  had  been  affected  with  that  malady,  from  milk¬ 
ing  the  diseased  cows.  On  inquiry,  I  found  three  of  the  men  servants,  namely,  Thomas 
Edinburgh,  Thomas  Grimshaw  and  John  Clarke,  had  been  affected  with  the  cow-pox,  hub 
not  with  small-pox.  I  induced  them  to  be  inoculated  for  the  small-pox  :  and,  with  the 
view  of  ascertaining  the  efficacy  of  the  variolous  infection  employed,  William  Kent  and 
Thomas  East,  neither  of  whom  had  either  the  cow-pox  or  the  small-pox,  were  also  inocu¬ 
lated.  * 

Three  of  these  men,  viz  :  Edinburgh,  East  and  Kent,  were  inoculated  in  each  arm  with 
perhaps  a  larger  incision,  and  more  matter,  than  usual,  on  Sunday,  June  17th,  by  Mr. 
Lucas;  and  Dr.  Woodville  and  myself  were  present.  The  matter  was  taken  from  a  hoy 
present,  who  had  been  inoculated  fourteen  days  before  this  tirue,  and  who  was  oblig¬ 
ingly  provided  by  Dr.  Woodville. 


CASE  1. 

Thomas  Edinburgh,  aged  twenty-six  years,  had  lived  at  the  farm  the  last  seven  years.  Had  never  had 
the  small -pox,  nor  chicken  pox,  nor,  any  eruption  resembling  that  of  these  diseases,  but  the  cow-pox,  which 
lie  was  certainly  affected  with  six  years  ago.  He  was  so  lame  from  the  eruption  on  the  palm  of  the  hands 
as  to  leave  his  employ,  in  order  to  bo  for  some  time  in  a  public  hospital  ;  and  he  testified  that  his  fellow- 
servant,  Grimshaw,  was  at  the  same  time  ill  with  the  same  disorder.  A  cicatrix  was  seen  on  the  palm  of 
the  hands,  but  none  on  the  other  part.  He  said  that  for  three  days  in  the  disease,  he  suffered  from  pain 
in  the  axillie,  which  were  swollen  and  sore  to  the  touch.  According  to  the  patient’s  description,  the 
disease  was  uncommonly  painful  and  of  long  continuance  ;  whether  on  account  of  the  unusual  thickness 
of  the  skin,  which  was  perceived  by  the  lancet  in  inoculation,  future  observation  may  determine. 

THIRD  DAY. — TUESDAY,  JUNE  19. 

A  slight  elevation  appeared  on  the  parts  inoculated.  No  disorder  was  perceived  of  the  constitution,  nor 
complaint  made.  ® 

FIFTH  DAY — THURSDAY,  21. 

The  appearance  on  the  part  inoculated,  of  the  left  arm,  was  like  that  of  a  gnat  bite,  and  Mr.  Wackfel, 
apothecary  to  the  Small-Pox  Hospital,  observed  that  the  inflammation  seemed  too  rapid  for  that  ot  the 
variolous  infection,  when  it  produces  the  small-pox.  On  the  other  arm  there  had  been  a  little  scab,  which 
was  rubbed  off,  leaving  only  a  just  visible  red  mark.  No  complaint  was  made. 

EIGHTH  D  A.Y — SUNDAY,  14. 

The  inflammation  on  the  left  arm  had  subsided,  and  there  was  in  place  of  it,  a  little  scab.  The  right 
arm  as  before.  Has  remained  quite  well. 

Sent  the  patient  with  Mr.  Wackfel  to  the  Small-Pox  Hospital,  where  he  was  inoculated  a  second  time, 
with  matter  from  a  person  present,  who  then  labored  under  the  small-pox. 

FOURTH  DAY  AFTER  SECOND  INOCULATION,  WEDNESDAY,  27. 

A  little  inflammation  appeared  on  the  part  inoculated  of  one  arm,  but  uone  of  that  of  the  other.  Except 
some  slight  pains  and  headache  on  Monday  last,  had  remained  quite  well. 

EIGHTH  DAY  AFTER  SECOND  INOCULATION,  SUNDAY,  JULY  1. 

A  little  dry  scab  was  upon  each  part  inoculated.  No  symptoms  of  disorder  had  appeared . 


CASE  II. 

Thomas  Grimshaw,  aged  about  thirty  years.  Had  lived  in  town,  at  the  farm  only  seven  weeks,  but  six 
years  ago  also  lived  at  this  place,  when  he  vas  affected  with  the  cow-pox  ;  and  he  testified  that  his  fellow - 
servant,  Edinburgh,  was  at  the  same  time  ill  of  the  same  disease  Grimshaw  said  he  had  pains  and  sore 
ness  on  touching  the  axillae  during  the  illness,  buthegot  much  sooner  well  than  Edinburgh. 

On  Tuesday,  the  nineteenth  Juno,  Grimshaw  was  inoculated  in  both  arms,  at  the  Small-Pox  Hospital, 
from  a  patient  then  ill  of  the  small-pox. 

THIRD  DAY— THURSDAY,  21. 

A  little  inflammation  and  fluid  appeared  under  a  lens  in  the  parts  inoculated,  as  it  the  infection  had  taken 
effect.  Remained  quite  well. 

SIXTH  DAY— SUNDAY,  24. 

Inflammation  which  had  spread  near  the  parts  inoculated  has  disappeared  ;  and  now  nothing  was  seen 
but  a  dry  scab  on  them .  Had  not  been  at  all  disordered.  He  was  inoculated  this  day  a  second  time,  as  be¬ 
fore,  at  the  Small-Pox  Hospital. 

FOURH  DAY — SECOND  INOCULATION,  WEDNESDAY,  JUNE  27. 

Not  the  least  inflammation  from  the  last  inoculation,  nor  any  complaint. 


Cow-Pox ;  George  Pearson1  M.  D. 


71 


EIGHTH  DAY — SECOND  INOCULATION,  SUNDAY,  JULY  1. 

Not  the  smallest  inflammation  from  the  inoculation.  Had  remained  quite  well. 


CASE  III. 

John  Clarke,  twenty-six  years  of  age,  had  the  cow-pox  ten  years  ago  at  Abingdon,  where  he  was  under 
the  care  ot  a  medical  practitioner  of  that  place.  He  was  inoculated  by  Mr.  Wackfel,  at  the  Small-Pox 
Hospital,  on  Tuesday,  June  29th,  from  a  patient  affected  with  the  small  pox. 

THIRD  DAY — THURSDAY,  JUNE  21. 

There  was  inflammation,  and  a  fluid  in  the  parts  inoculated:  but  these  appearances  were  judged  to  be 
premature,  with  respect  to  the  small  pox. 

SIXTH  DAY — SUNDAY,  JUNE  24. 

The  appearances  of  inflammation  and  fluid  in  the  right  arm,  were  such  as  to  make  it  doubtful  whether 
or  not  the  variolous  infection  had  taken  effect ;  but  there  was  no  such  appearance  on  the  lelt  arm,  the  in¬ 
flammation  being  gone. 

He  was  this  day  inoculated  a  second  time  at  the  Small-Pox  Hospital,  from  a  patient. 

EIGHTH  DAY  AFTER  SECOND  INOCULATION,  SUNDAY,  JULY  1. 

No  effect  but  inflammation,  and  afterwards  festering,  from  the  second  inoculation. 

The  inflammation  on  the  right  arm,  from  the  first  inoculation,  went  off  in  a  day  or  two  after  the  last, 
report.  He  had  remained  quite  well  in  all  respects. 


CASE  IV. 

William  Kent,  thirty  years  of  age,  had  lived  at  Mr.  Willan’s  farm  about  eight  weeks.  Had  never  la¬ 
bored  under  the  small-pox,  but  said  he  had  gone  through  the  chicken-pox  :  and  he  had  been  told  that  he 
had  been  affected  with  a  disorder,  which  was  supposed  to  be  the  cow-pox,  when  lie  was  four  years  of  age. 
He  was  inoculated  under  the  same  circumstances  as  Thomas  Edinburgh,  by  Mr.  Lucas,  on  Sunday, 
June  17. 

THIRD  DAY — TUESDAY,  19. 

The  parts  inoculated  were  scarcely  red,  yet  their  appearance  was  such,  when  viewed  under  a  lens,  as  to 
render  it  probable  the  small-pox  would  take  place.  Remained  quite  well. 

FIFTH  DAY — THURSDAY,  21. 

The  inoculated  part  of  the  left  arm  appeared  red  ;  and  on  viewing  it  with  the  magnifier,  a  little  bladder 
was  seen  in  the  middle.  The  same  was  the  state  of  the  right  arm,  but  less  evidently.  Continued  free  from 
illness.  Pulse  94  after  walking  two  miles  in  a  very  hot  day. 

EIGHTH  DAY — SUNDAY,  24. 

The  left  arm  was  more  inflamed,  and  a  small  flat  vesication  appeared  in  the  middle  of  the  inflamed  part. 
The  right  arm  was  affected  in  the  same  manner,  but  in  a  less  degree.  It  was  not  doubted  that  he  was  in¬ 
fected  with  the  variolous  disease,  especially  as  he  complained  of  soreness  of  the  arm  pits,  and  he  has  been 
very  much  disordered  the  two  last  nights,  having  had  pain  of  his  bones  in  general,  and  headache,  and  had 
felt  very  hot,  but  not  chilly.  Pulse  was  only  eighty,  and  his  tongue  had  the  healthy  appearance,  nor  was 
he  thirsty. 

ELEVENTH  DAY — WEDNESDAY,  27. 

Variolous  eruptions  in  number,  perhaps  twenty  or  thirty  had  made  their  apj>earance. 

FIFTEENTH  DAY — SUNDAY,  JULY  1. 

Eruptions  are  in  a  suppurated  state.  Had  been  quite  well,  and  he  has  continued  his  employ  during  the 
present  hot  week. 


CASE  V. 

Thomas  East.,  aged  twenty-one  years,  he  believed  he  bad  never  been  affected  with  the  small-pox,  and 
certainly  not  with  the  cow-pox.  There  were  several  cicatrices,  however,  on  his  arms,  exactly  like  those 
from  the  small-pox,  and  if  the  inoculation  had  not  succeeded,  I  should  have  been  disposed  to  conclude  that, 
he  had  already  gone  through  that  disease. 

He  was  inoculated  by  Mr.  Lucas  on  Sunday,  seventeenth  June,  at  the  same  time,  and  under  the  same 
circomstances,  as  Thomas  Edinburgh  and  William  Kent, 

THIRD  DAY — TUESDAY,  JUNE  19. 

Only  a  just  visible  scab  on  the  parts  inoculated,  and  it  was  thought  tbe  infection  bad  not  taken  effect. 
Remained  well. 

Went  to  the  Small-Pox  Hospital,  and  was  inoculated  a  second  time. 

FIFTH  DAY — THURSDAY,  JUNE  21. 

Redness  appears  now  in  the  parts  inoculated,  as  if  both  the  first  aud  second  inoculation  had  taken 

effect . 


Coir -Fox  ;  George  Pearson ,  M.  I). 


EIGHTH  DAY — SUNDAY.  JUNE  24. 

All  the  four  parts  inoculated  were  so  much  inflamed,  that,  it  seemed  now  doubtful,  whether  the  small  pox 
would  come  on.  Parts  tirst  inoculated,  less  inflamed  than  those  of  the  second  inoculation:  and  the  right 
arm  more  inflamed  than  the  left.  I’ains  of  the  axilla}  were  complained  of,  which  were  a  little  swelled,  and 
sore  to  the  touch.  There  were  no  symptoms  of  fever. 

ELEVENTH  DAY — WEDNESDAY,  JUNE  27. 

About  a  dozen  variolous  eruptions  were  now  out.  No  complaints  were  made. 

FIFTEENTH  DAY — SUNDAY,  JULY  1. 

Variolous  eruptions  were  in  a  state  of  suppuration,  Ther  -  was  a  suppuration  of  the  parts  inoculated 
pretty  much  alike,  from  both  the  first  and  second  inoculation. 

It  was  thought  the  second  inoculation  had  excited  inflammation  in  the  parts  first  inoculated,  which  other¬ 
wise  might  not  have  taken  place  so  soon,  or  not  at  all. 

Notwithstanding  the  hot  weather  for  the  last  fortnight,  the  temperature  being  generally  68o  to  78°  of 
Fahrenheit’s  thermometer,  the  patients  who  took  the  small  pox  were  so  little  disordered,  that  they  con¬ 
tinued  their  daily  work. 

No  treatment  was  prescribed  previously  to  inoculation,  all  the  men  being  in  health  ;  but  every  other  day 
after  it,  for  a  fortnight,  they  were  purged  with  salts,  and  directed  to  abstain  from  strong  liquors,  and  to  eat 
very  little  animal  food. 

I  did  not,  require  any  further  evidence  than  what  I  have  already  procured,  in  my  own  practice,  to  satisfy 
me,  that  the  quantity  of  variolous  matter  does  not  influence  the  disease  ;  but  on  account  of  some  late  asser¬ 
tions.  that  the  disorder  is  rendered  milder  by  using  a  smaller  quantity  of  matter  in  the  above  cases,  a 
larger  quantity  was  purposely  inserted  ;  yet  milder  cases  than  the  above  could  not  he  desired, 

It  should  also  be  noticed  that  the  three  patients  above  mentioned,  who  did  not  take  the  infection  on  inoc¬ 
ulation  for  the  small  pox,  had  their  children  soon  afterwards  inoculated,  who  all  took  the  small-pox,  These 
men  lived  in  the  same  apartments  with  their  children  duiing  the  illness  of  the  small-pox  ;  but  not  one  of 
them  was  infected. 

We  have  seen  in  the  above  cases,  five  persons  inoculated  for  the  small-pox,  under  the  most  favorable  cir 
cumstances  for  the  efficaciousness  of  the  infection  ;  two  of  them  took  the  disease  from  o  ce  inserting  vario¬ 
lous  matter,  but  the  other  three  were  uninfected,  although  the  matter  was  twice  inserted  ;  and  although 
they  were  exposed  to  infection,  by  living  with  their  children  while  they  were  suffering  under  the  small¬ 
pox. 

The  three  patients  who  did  not  take  the  small-pox.  gave  strong  circumstantial  evidence  that  they  had 
been  affected  with  the  cow-pox,  but  not  with  the  small  pox.  The  other  two  patients,  who  were  infected 
with  the  small  pox,  there  is  no  reason  to  doubt  were  as  credible  persons  as  the  former,  and  they  attested 
that  they  had  not  had  the  small-pox  ;  which  attestation  being  vei  illed  by  their  taking  the  disease,  it  would 
be  injustice  to  question  the  other  part  of  their  evidence,  th  it  they  had  not  labored  under  the  cow-pox. 
For.  as  to  the  mere  traditionary  story  of  William  Kent  having  the  cow-pox,  no  circumstance  supported  the 
truth  of  it  against  the  extreme  improbability  of  a  boy  of  four  years  of  age,  or  under,  suffering  a  disease 
which  is  contracted  by  handling  the  teats  of  cows  in' milking,  when  they  are  so  difficult  to  manage,  that 
male,  instead  of  female  servants,  must  then,  generally,  bo  emplo\  cd.  I n  some  plact  s,  it  seems  the  eruptive 
disease,  which  is  known  to  medical  men  by  the  name  of  tho  chicken,  or  swine-pox.  is  called  by  the 
lower  orders  of  people,  cow  pox,  Mr.  Giffard  takes  notice  that  “there  are  two  kinds  of  cow-pox,” 
the  one  is  attended  with  eruptions  of  the  skin  in  general,  and  sometimes  produces  pits  ;  but 
the  other  is  a  disease  confined  to  the  hands.  It  is  most  probable  that  Kent’s  eruptive  disease, 
when  a  child,  was  the  chicken-pox,  if  he  really  had  an  eruptive  disease.  One  of  three  reasons 
may  be  assigned  for  the  above  three  patients  not  taking  the  small-pox  :  viz.  1.  That  they  had 
already  suffered  the  small  pox.  2.  That  they  had  not  had  this  disease,  and  that  their  constitutions'  were 
not  excitable  at  the  time  they  were  inoculated  ;  for  one  can  scarce  suspect  the  failure  to  be  from  the  mode 
of  inserting  the  matter  3.  That  they  were  not  capable  of  infection  with  the  small-pox  poison,  because 
they  had  undergone  the  cow-pox.  In  respect  of  the  first  assignable  reason,  it  must  be  allowed  that  a  person 
may  go  through  the  small-pox,  and  the  disease  be  so  slight,  that  it  is  neither  noticed  by  the  patient,  nor  by 
his  friends,  But  such  unobserved  cases  are  extremely  rare,  and  they  bear  so  very  small  a  proportion  to  the 
others,  that  for  threesuch  cases  to  occur  together  on  the  present  occasion,  seems  to  be  barely  a  possibility. 

With  regard  to  the  second  assigned  reason,  probably  about  one  out  of  fifty  persons  does  not  take  the 
small-pox  by  inoculation  of  the  same  matter,  aud  in  the  same  manner;  and.perhaps  not  more  than  one  out 
of  fifty  of  those  who  are  not  infected  by  a  first  inoculation,  fail  to  he  infected  on  a  second  inoculation.  Ac¬ 
cording  to  this  representation,  then  it  appears  to  be  a  mere  possibility  that  the  smail-pox  poison  should  not 
take  effect,  for  the  second  assignable  reason,  namely,  a  peculiar  disposition  ;  especially  as  the  patients  were 
subsequently  under  very  favorable  circumstances,  for  being  infected  with,  variolous  effluvia. 

With  regard  to  the  third  assignable  reason,  as  in  so  many  instances  now  recorded,  itappears  that  persons, 
who  have  undergone  the  cow-pox,  are  not  susceptible  of  the  small  pox  :  and  as  the  failure  of  the  inoculation 
cannot  be  imputed  with  justice  to  the  two  other  causes above  ment  ioned,  it  seems  most  reasonable  to  impute 
the  inefficacy  ot  tho  variolous  poison  in  the  above  three  -instances  to  a  state  of  inexcitability,  produced  by 
the  cow-pox  poison 

On  making  inquiries  at  Mr.  Kendal’s  farm,  for  milch  cows,  on  the  New  Road,  Marybone,  a  female  servant 
informed  me  that  she  labored  under  the  cow-pox  many  years  ago,  when  she  lived  in  Suffolk  where  this 
disease  prevails.  From  her  description  I  could  not  doubt  that  she  had  really  been  affected  with  the  cow- 
pox.  After  this  she  took,  what  she  believed  to  be  the  small-pox,  from  an  infant,  which  was  nourished  by 
her  breasts.  A  fever  preceded  the  eruptions,  which  were  only  about  fifty  in  number,  and  they  disap 
peared  in  a  few  days  after  they  came  out.  If  the  latter  part  of  this  testimony  is  accurate,  one  cannot  admit 
this  case  to  lie  an  example  ot  the  small-pox,  taking  place  in  a  constitution  which  had  previously  been  af 
fected  wtih  the  cow-pox . 

At  this  farm,  a  cow  was  shown  to  me  which  was  said  to  be  affected  with  the  cow-pox  :  on  examination, 
the  disoider  appeared  to  be  in  its  last  stage  of  desiccation.  However,  eight  persons,  who  had  not  undermine 
the  small  pox,  were  inoculated  with  the  scabs  of  this  disorder,  but  no  disease  ensued. 

Gn  calling  at  IHr.  Rhodes  milk  farm  on  the  Hampstead  Road,  where  there  is. a  very  larve  stock  of  cows  I 
found  the  cow-pox  had  not  fallen  under  his  observation  ;  but  two  of  the  male  servants  were  well  acquainted 
with  some  parts  of  its  history.  It  appeared  also  on  inquiry,  that  one  of  the  cows  had  really  labored  under 
the  disease  two  months  before,  namely,  in  May  last,  but  tiie  milker  was  not  infected,  because  he  said  there 
were  no  cuts  on  his  hands,  or  abrasion  of  the  cuticle  It  was  described  very  clearly  to  be  a  different  disease 
from  the  common  inflammations  and  eruptions  which  produce  scabbed  nipples.  One  of  the  male  servants 


Cow-Pox ;  George  Pearson ,  M.  I). 


73 


had  often  seen  the  disease  in  Wiltshire  and  Gloucestershire.  Tho  milkers,  he  said,  were  sometimes  so  ill, 
as  to  lie  in  bed  ior  several  days,  and  there  was  a  fever  at  the  beginning,  as  in  the  small-pox,  hut  that  no 
one  ever  died  of  it.  He  had  known  many  persons  who  had  laboured  under  the  cow-pox,  but  who  bad- 
never  suffered  the  small-pox,  although  it  prevailed  in  their  own  families  ;  except  in  one  instance  in  which 
he  was  told  that  the  person  who  took  the  small-pox,  had  gone  through  the  cow-pox  when  a  child.  The 
same  servant  said  it  was  a  common  opinion,  that  people  who  have  been  affected  with  the  cow-pox,  to  use 
his  own  words,  are  “hard  to  take  the  small  pox.” 

Mr.  Francis,  who  keeps  a  farm  for  milch  cows  on  the  road  to  Somers’ Town,  had  seen  the  disease  se  veral 
times  in  the  autumn  among  his  cattle,  and  he  knew  that  it  was  very  apt  to  produce  paintul  sores  on  the 
milkers  ;  but  he  had  never  heard,  or  observed,  that  it  prevented  persons  from  having  the  small-pox. 

He  said  that  three  years  ago,  in  tho  spring,  the  disease  prevailed  at  several  farms  on  the  Hew  Hoad. 

A  male  servant  of  Mr  Francis,  who  has  a  good  understanding,  and  is  a  man  of  veracity,  and  had  lived  in 
dairy  farms  all  his  life,  stated,  “that  he  had  seen  the  cow-pox  thirty-five  years  ago  at  King's  Wood,  in 
Somersetshire,  and  frequently  there,  and  in  London  since  that  time.  The  disease,  he  said  was  thenvul. 
garly  called  tlis  cow-pox  ;  it  appeared  on  the  teats  and  udders  with  fiery  or  iiame  like  eruptions — was  very 
infectious  among  the  cows  and  the  milkers;  but  never  knew  either  human  creature,  or  beast  die  of  it.  It 
affects  the  hands  and  arms  of  the  milkers  with  painful  sores,  as  large  as  a  sixpence,  which  last  for  a  month 
or  more,  so  as  to  disable  the  sufferers  from  continuing  their  employment.  The  disease  breaks  out  especially 
in  the  spring,  but  occasionally  at  other  times  of  the  year.  Most  of  the  cows  in  his  master’s,  Mr,  Francis; 
farm,  were  infected  three  years  ago  in  the  spring  at  which  times  many  of  the  milkers  were  also  infected- 
A  new  cow  is  very  liable  to  take  the  disease.  He  had  always  understood  that  a  person  who  had  had  the  cow' 
pox,  could  not  take  the  small-pox,  and  never  knew  in  the  course  of  his  life  an  instance  of  the  small-pox  in 
such  persons. 

The  following  instances  fell  under  his  own  observation:  a  fellow  male  and  a  female  servant  were  affected 
with  the  cow-pox  ;  some  time  after  this,  the  parish  in  which  they  lived  were  in  general  inoculated  for  the 
small-pox,  but  these  two  persons,  who  had  never  labored  under  the  small -pox,  could  not  bo  infected  with 
this  disease;  nor  did  they  take  it,  although  they  subsequently  lived  with  their  children  while  they  were 
suffering  the  stnall-pox.  Ho  also  believed,  audit  was  a  common  opinion  in  many  parts  of  the  country, 
that  persons  who  have  undergone  the  small-pox  cannot  take  the  cow  pox.  He  himself  labored  under  the 
inoculated  small-pox  when  seventeen  years  of  age,  but  never  took  the  cow-pox,  although  he  had  milked  a 
great  number  of  cows  laboring  under  the  disease.  He  had  never  known  either  a  human  creature,  or  cow 
have  the  disease  more  than  once.  He  had  the  measles  previously  to  the  small-pox,  as  well  as  the  hooping 
cough. 

At  some  other  farms,  near  London,  where  milch  cows  are  kept,  I  found  the  disorder  was  not  known  either 
to  the  masters,  or  servants, 

Dr.  Haygarth  very  kindly  wrote  me  a  letter  from  Bath,  on  the  30th  of  August  last,  in  which  he  says. 
“To  none  of  your  questions^  concerning  the  cow-pox,  can  I  give  any  answer  from  my  own  knowledge.  Of 
such  a  distemper,  I  never  heard  among  the  Cheshire,  or  Welsh  farmers.  My  first  intelligence  upon  this 
subject  came  from  my  friend,  Dr.  Worthington,  of  Ross,  some  time  ago.  He,  as  well  as  another  friend,  Dr, 
Pereival,  speak  very  favorably  of  Dr.  J enner,  on  whose  testimony  the  extraordinary  facts  he  has  published 
at  present  principally  depend.” 

I  feel  most  sensibly  the  great  favor  shown  to  me  by  Professor  Wall,  of  Oxford.  Although  this  gentle¬ 
man’s  zeal  and  ability  in  promoting  useful  inquiries  are  acknowledged,  I  cannot  but  attribute  the  great 
pains  which  he  bestowed  to  procure  answers  to  my  queries  in  so  short  a  time  as  I  required,  in  part,  to  the 
friendship  founded  in  the  days  of  academical  studies  ;  to  use  this  amiable  gentleman’s  own  words— “those 
days  of  free,  manly,  and  liberal  conversation  which  I  reflect  on  with  infinite  pleasure. 

The  information  belonging  to  this  place,  from  Professor  Wall,* *  is  the  answer  to  the  question,  whether 
there  is  sufficient  evidence  that  the  small-pox  cannot  infect  a  person  who  has  once  had  the  cow-pox,  at¬ 
tended  with  fever:  and  if  there  has  been  a  local  affection  without  fever,  is  such  person  still  capable  of  tak¬ 
ing  the  small-pox  ? 

“I  receive  butone  answer  to  the  two  different  modes  of  the  question,  which  is,  that  any  person  who  has 
ever  had  the  cow-pox,  has  never  been  known  to  have  the  small-pox.” 

A  servant  who  has  kept  the  cows  of  a  considerable  dairy-farm  in  this  neighborhood  a  great  many  years, 
told  me  that  he  had  the  cow-pox  early  in  life.  Tet  about  six  or  seven  years  ago  he  wished,  for  security, 
to  be  inoculated  for  the  small-pox— the  operation  was  performed  three  several  times,  but  no  disorder  nor 
eruption  ensued — the  Surgeon,  a  gentleman  of  great  eminence  in  this  place,  asked  him  if  he  had  ever  had 
the  cow-pox;  upon  his  answering  yes,  the  Surgeon  replied.  Then  it  is  useless  to  make  any  farther  trial. 
This  servant,  the  next  year,  had  several  children  inoculated  by  Sutton.  He  was  with  them  all  the  time  till 
their  recovery,  but  din  not  receive  the  infection.  A  servant-girl  at  another  considerable  farm,  told  me 
she  had  the  cow-pox  early  in  life  ;  several  years  after  she  was  inoculated,  but  nothing  took  place,  except 
the  appearauce  of  red  blush  round  the  incision  similar,  I  suppose,  to  what  Dr.  Jenner  mentions. 

This  red  suffusion  has  been  hastily,  by  some  inoculators,  regarded  as  a  proof,  that  the  system  has  been 
infected  with  the  virus  of  the  small-pox  ;  but  neither  this  appearance,  nor  even  a  much  more  considerable 
affection  of  the  arm  is  always  sufficient  security  against  future  infection,  unless,  there  has  been  some  erup¬ 
tion. — See  Memoirs  of  the  Medical  Society.” 

From  Mr.  Dolling,  an  Iuoculator  at  Blandford,  I  have  received  important  intelligence,  for  which  lam 
under  further  obligations  to  the  Rev.  Herman  Drewe.t  “Mr.  Dolling  has  inoculated  for  the  small  pox  a 
great  number  of  persons,  who  said  they  had  been  affected  with  the  cow-pox,  and  very  few  of  them  took  the 
infection,  to  produce  the  small-pox,  and  he  is  of  opinion  that  those  who  took  the  small-pox,  were  mistaken 
in  supposing  they  had  really  labored  under  the  cow-pox.  In  one  family  five  out  of  seven  children  took  the 
cow-pox,  by  handling  the  teats  of  a  cow  affected  with  the  cow-pox  :  these  seven  children  were  inoculated 
for  the  small-pox,  but  none  took  the  infection,  except  the  two  who  had  not  labored  under  the  cow-pox. 

Dr.  Croft  tells  me,  that  in  Staffordshire,  to  his  knowledge,  the  fact  has  been  long  known,  of  the  cow. pox, 
which  prevails  in  that  county,  affording  an  exemption  of  the  human  subject  from  the  small-pox.  This  gen¬ 
tleman  affords  me  an  unequivocal  proof  of  his  conviction  of  the  safety  and  efficacy  of  the  inoculated  Cow- 
pox,  by  his  application  to  me  for  matter,  in  order  to  inoculate  one  of  his  own  children. 

My  lwmorable  friend,  Mr.  Edward  Howard,  has  been  assured  on  very  good  authority,  that  of  a  relation, 
who  is  an  officer  in  the  Oxfordshire  Militia,  that  it  is  a  received  opinion  among  the  soldiers,  that  it  is  un¬ 
necessary  to  be  inoculated  for  the  small-pox,  if  they  have  already  labored  under  the  cow-pox,  as  many  of 
them  have  done. 

Dr.  Redfearn  of  Lynn*  informs  me,  that  “the  cow-pox  is  a  common  disease  among  the  cattle  in  this  part, 
and  the  fa  mers  have  made  use  of  the  appellation  cow-pox  for  near  thirty  years,  although  totally  ignorant 
of  the  disease  existing  in  the  West  of  England.”  But, 

*See  Dr.  Wall’s  Letter,  Oxford,  September  3,  1798. 

tThe  Rev.  H.  Drcwe’s  Second  Letter,  Septemdor  17.  1798. 

*Dr.  Redfearn’s  Letter,  September  15  1798. 


n 


Coic-Pox;  George  Pearson ,  M.  1). 


Dr.  Alderson,  of  Norwich*  acquaints  me,  that  there  is  reason  to  believe  the  disease  is  not  known  in  his 
neighborhood. 

My  correspondents  in  the  North  and  East  Hidings  of  Yorkshire,  in  Durham,  in  Lincolnshire,  and  in  the 
neighborhood  of  Windsor,  acquaint  me  that  the  cow-pox  is  not  known  in  those  parts.  Hut  from  the- 
success  which  I  have  had  in  discovering  the  disease,  by  making  a  strict  inquiry  in  farms,  where  it  was  be 
lieved  not  to  exist,  1  can  scarce  doubt,  that  it  breaks  out  occasionally  in  every  part,  where  a  number  of 
cows  are  kept,  and  that  the  infection  is  widely  disseminated 
I  do  not  find  that  the  cow-pox  is  known  in  Lancashire.  Dr.  Currie,  t  of  Liverpool,  obligingly  answers 
my  letter;  he  says,  ‘I  have  made  inquiries  among  the  farmers,  but  I  have  not  been  able  to  timl  one  who  is 
acquainted  with  the  disease.  Of  course  I  cannot  answer  any  of  your  queries.  My  friend,  Dr.  Percival,  of 
Manchester,  who  is  now  here,  never  heard  of  the  cowT-pox  in  this  county,  any  more  than  myself.” 

II.  Person  who  have  been  affected  with  the  specific  fever,  and  peculiar  local  disease, 
by  inoculation  of  the  cow-pox  infection,  who  had  not  previously,  undergone  the  small¬ 
pox,  are  thereby  rendered  unsusceptible  of  the  small-pox. 

The  first  set  of  evidences  of  this  fact  are  those  of  Dr.  lenner,  in  the  cases  xvii,  six,  xx,  xxi,  xxii,  xxiii, 
They  are  ins  ances  of  inoculation  of  the  cow  pox  as  in  the  small-pox,  with  matter  taken  from  the  teats  of 
cows.  A  fever  like  that  of  the  small-pox  arose  in  six  to  nine  days  after  the  incision,  hut  scarce  of  more 
than  twenty-four  hours,  duration ;  attended  with  an  inflammatory  appearance,  or  erythematous  efflores¬ 
cence  around  the  parts  inoculated,  and  postulops  sores  of  those  parts  ;  which  do  not  suppurate,  but  remain 
limpid  till  they  disappear  ;  and  there  is  no  eruption  of  other  parts  of  the  skin,  as  in  the  small-pox. 

In  the  cases  of  inoculation  under  Dr.  Jenner,  the  local  affection  was  commonly  as  slight  as  in  the  inocu¬ 
lated  small-pox,  but  sometimes  there  appeared  a  disposition  to  a  more  extensive  inflammation  of  the  skin 
around  the  parts  in  which  the  matter  was  inserted.  “It  seemed  to  arise  front  the  state  of  the  pustule, 
which  spread  out  accompanied  with  some  degree  of  pain,  to  about  half  the  diameter  of  a  sixpence.  L5y  the 
application  of  mercurial  ointment  to  the  inflamed  parts,  (as  is  practised  in  the  inoculated  small  pox)  the 
complaint  soon  subsided.  To  prevent  inflammation  of  the  skin,  caustic  was  also  applied  to  the  vesicle  of 
the  inoculated  part,  to  excite  a  different  kind  of  inflammation  ;  but  the  precaution  was  perhaps  unnecessary, 
as  a  third  patient  had  nothing  applied,  and  the  arm  scabbed  quickly,  w  ithout  any  er\  sipelas. 

One  of  these  patients  inoculated  w’itli  t  he  cow-pox  was  only  six  months  old,  and  who  took  the  disease.  In 
none  of  the  above  cases,  after  the  cow-pox;  could  the  small-pox  ho  excited,  by  repeated  inoculation.  The 
confidence  of  Dr  Jenner,  in  the  safety  and  efficacy  of  the  inoculation  of  the  cow-pox  is  unequivocally  de¬ 
clared  by  the  modulation  of  his  own  son,  JR.  E.  Jenner,  aged  elevonmon  tlis ;  although  the  poison  did 
not  take  effect  in  this  instance.  The  project  of  inoculation  of  the  cow-pox  occurred  to  other  practioners, 
antecedently  to  Dr  Jenner’s  experiments. 

Mr.  Drewe,  in  his  letter  above  cited,  speaks  of  the  practice.  He  says,  “Mr.  Bragge  and  I  endeavored  to 
try  the  experiment  of  inoculating  with  the  matter  of  the  cow-pox,  but  from  the  scarceness  of  the  disease, 
and  unwillingness  of  patients,  we  were  disappointed.” 

Mr.  Pulteney  informs  me,  that  “a  very  respectable  practioner  acquainted  him  that  of  seven  children 
whom  he  had  inoculated  for  the  small-pox,  five  had  been  previously  infected  with  the  cow-pox  purposely,  by 
being  made  to  handle  the  teats  and  udders  of  infected  cows;  iu  consequence  of  which,  they  suffered  the 
distemper.  These  five,  after  inoculation  for  the  smallpox,  did  not  sicken;  the  other  two  took  the  dis¬ 
temper.” 

Farther,  “A  farmer  in  this  country  inoculated  his  wife  and  children  with  matter  taken  from  the  teat  of  a 
cow.  At  the  end  of  a  week  the  arms  inflamed,  and  the  patients  were  so  far  affected,  as  to  alarm  the  farmer, 
although  unnecessarily,  and  incline  him  to  call  in  medical  assistance.  They  all  soon  got  well,  and  were 
afterwards  inoculated  for  the  small-pox,  but  no  disease  followed.  I  was  not  applied  to  in  this  case,  but  the 
fact  is  sufficiently  ascertained.” 

Mr.  Downe  furnishes  me}  with  important  information  on  the  present  fact.  “E,  F.  r  ear  Bridport,  when 
about  twenty  years  of  age,  was  at  a  farm  house  when  the  dairy  was  infected  with  the  cow-pox.  It  being- 
suggested  to  him  that  it  would  be  the  means  of  preserving  him  from  the  small-pox,  which  he  had  never- 
taken,  if  he  would  submit  to  be  inoculated  with  the  cow-pox;  he  gave  his  consent  ;  he  was  infected  in  two 
or  three  places  in  his  hand  with  a  needle.  He  felt  no  inconvenience  till  about  a  week,  when  the  parts 
began  to  inflame,  and  his  hand  to  swell,  his  head  to  aoh,  and  many  other  symptoms  of  fever  came  on.  He 
was  recommended  to  keep  much  in  the  open  air,  which  he  did,  aiid  iu  four  or  live  days  the  symptoms  of 
fever  went  off,  as  the  maturation  of  the  hand  advanced.  The  parts  soon  healed,  leaving  permanent  scars. 
He  was  afterwards  inoculated  twice  by  my  grand-father,  and  a  considerable  time  after  twice  by  my  father, 
but  without  any  other  effect  than  a  slight  irritation  of  the  part,  such  as  is  occasioned  in  the  arms  of  persons 
Who  have  already  had  the  small-pox.  It  was  not  expected  at  the  time,  that  the  small-pox  poison  would  be 
effectual,  but  it  was  inserted,  partly  by  way  of  experiment,  and  partly  by  way  of  precaution,  the  small-pox 
being  then  in  the  family.  The  small-pox  has  been  repeated  sinco  in  his  own  family,  and  he  never  avoided  it, 
being  confident  that  it  was  not  possible  to  infect  him  with  this  disease,  The  next  case  by  Mr,  Downe, 
although  it  affords  defective  evidence,  is  not  useless,  “I  have  lately  conversed  with  a  person  who  was  in 
play,  inoculated  in  the  hand  with  the  cow-pox  matter.  The  wouitds  apparently  healed  for  a  time,  and 
then  inflamed.  He  had  a  swelling  in  the  axilla,  pain  in  the  head,  sickness,  and  slight  fever.  No  eruption 
took  place,  but  there  was  much  maturation  at  the  place  of  insertion,  and  considerable  scars  remain  ” 

Next  hear  what  Pi  ofesser  Wall  says  in  his  answer  to  the  question,  “Whether  the  disease  has  been  com 
municated  by  inoculation,  and  whether  it  has  produced  a  milder  or  more  severe  disease  than  in  the  casual 
way  1” 

“I  have||  not  yet  learnt  that  this  disorder  has,  in  this  part  of  the  country,  ever  been  propagated  by  inocu¬ 
lation  designedly.  It  has  been  communicated  to  persous  who  have  had  slight  wounds  from  thorns,  abra¬ 
sions  of  the  skin  from  other  causes,  perhaps  more  readily  than  in  the  common  way  ;  but  it  has  not  ap¬ 
peared  that  the  character  or  severity  of  the  disorder  has  been  altered  by  this  circumstance.” 

Mr.  Dolling, §  of  Blaudl'ord,  communicates  the  following:  “Mr.  Jnstings  of  Axminster  inoculated  his 
wife  aud  children  with  matter  taken  from  the  teats  of  a  cow  that  had  the  cow-pox  ;  in  about  a  week  after 
inoculation,  their  arms  were  very  much  inflamed,  aud  the  patients  were  so  ill,  that  the  medical  assistance 
of  Mr.  Meach,  of  Ferae,  was  called  for.  The  patients  did  well.  They  were  afterwards  inoculated  for  the 
small-pox  by  Mr.  Trobridge,  without  effect. 


*Dr  Alderson’s  Letter,  Norwich.  September  16.  1798. 
tDr.  Currie’s  Letter,  Liverpool,  September  8,  1796. 
tSee  Mr.  Downe’s  Letter  of  August  25,  1798. 
HProlessor  Wall’s  Letter,  above  cited. 

$Mr.  Drewe’s  Second  Letter,  above  cited. 


Cow-Pox ;  George  Pearson ,  M.  D. 


75 


III.  The  disease  produced  by  inoculating  with  the  matter  of  the  cow-pox.  does  not 
differ  from  the  disease  produced  by  inoculation  with  the  matter  from  the  human  animal  ; 
nor  is  any  difference  observed  in  the  effects  of  the  matter  from  the  first  human  subject 
infected  from  the  brute  animal,  or  from  the  matter  generated  successively,  in  the  second, 
third,  fourth,  or  fifth  human  creature  from  its  origin  in  the  brute. 

Tin's  important  fact,  at  present,  is  only  supported  by  the  instance  related  by  Dr.  Jenner,  in  the  cases  xix 
to  xxiii,  p.  37  to  14.  Hence,  according  to  these  instances,  the  poison  of  the  cow-pox  has  the  same  properties, 
as  appears  from  its  effects  on  the  human  constitution,  whether  it  be  generated  by  the  cow,  or  by  the  human 
animal ;  and  these  properties  are  the  same,  however  remote  from  the  origin  of  the  poison  in  tile  cow.  But 
it  has  not  been  determined  by  inoculating  the  teats  of  cows  with  the  matter  taken  from  the  cow,  and  with 
that  taken  from  the  human  creature  ;  that  the  properties  ot  the  poison  from  this  latter  source  are  the  same 
with  legat'd  to  the  brute,  as  those  of  the  matter  from  the  cow  with  regard  to  the  same  animal. 

I  apprehend  that  the  cow-pox  is  the  only  example  at  present  known,  of  a  permanent  specific  infectious 
disease  in  the  human  constitution,  produced  by  matter  from  a  different  species  of  animal ;  but  it  has  been 
often  conjectured,  that  many  of  the  infectious  diseases  of  the  human  species  are  derived  from  brutes. 

IV.  A  person  having  been  affected  with  the  specific  fever,  and  local  disease,  produced 
by  the  cow-pox  poison,  is  liable  to  be  again  affected  as  before  by  the  same  poison  ;  and 
yet  sucli  person  is  not  susceptible  of  tlie  small-pox. 

I  find  that  most  part  of  professional  men  are  extremely  reluctant  in  yielding  their  assent  to  this  fact. 
Some,  indeed,  reject  it  in  the  most  unqualified  terms.  They  are  not  averse  from  admitting  the  evidence, 
that  the  cow-pox  may  affect  the  same  constitution  repeatedly  ;  or  even  that  a  person  having  had  this  disease,’ 
is  unsusceptible  of  the  small-pox  ;  but  that  the  constitution  having  suffered  the  cow-pox,  should  still  be 
susceptible  of  this  disease,  and  not  he  susceptible  of  the  small-pox,  is  an  assertion  with  regard  to  which, 
they  demur  to  acquiesce.  The  unfavorable  reception  of  the  evidence  for  this  fact  does  not  seem  to  arise  so 
much  from  the  observations  in  support  of  it,  being  suspected  to  be  inaccurate,  or  sufficiently  full  and  com¬ 
plete.  as  from  its  appearing,  as  they  say,  absurd  and  inconceivable.  On  inquiring  why  the  fact  appears  in 
this  light,  we  find  it  is  because  there  is  no  support  from  any  other  analogous  fact.  There  is.  in  reality,  no 
analogous  fact.  We  have  facts  which  show  that  a  person  having  undergone  certain  diseases,  occasioned 
by  particular  poisons,  in  some  instances  is,  and  in  others  is  not,  again  susceptible  of  the  same  disease,  by 
tlie  same  poison  ;  but  the  instance  before  us  is  the  first  which  has  been  observed  of  the  co'  sitution  being, 
rendered  inexcitable  to  a  disease,  from  a  given  morbid  poison,  bv  having  suffered  a  different  disease 
from  another  different,  poison,  and  yet  it  remains  suspectible  of  this  different  disease  by 
this  given  morbid  poison.  In  the  firsl  instance  of  certain  new  facts,  it  is  easy  to  conceive  that  there 
may  he  no  analogous  fact  to  the  one  discovered.  When  the  small  pox  first  broke  out,  on  its  being  discovered 
that  the  same  constitution  could  not  undergo  this  disease  a  second  time,  no  analogous  fact  was,  I  think, 
then  known;  and  on  that  account  it  probably  was  not  admitted  without  much  hesitation.  But  on  a  subse¬ 
quent  discovery  that  the  same  constitution  could  not  be  infected  more  than  once  with  the  measles,  this, 
as  well  as  the  former  fact,  readily  found  acceptance.  An  evidence  for  a  fact  ought  not  to  be  rejected, 
because  it  is  incomprehensible  or  inconsistent  with  what  is  already  known  ;  but  on  tlie  present  occasion,  if 
tlie  subject  be  well  considered,  it  does  not  seem  to  be  difficult  to  conceive  that  a  change  may  be  effected  in 
the  human  constitution,  by  a  disease  from  a  morbid  poison,  so  as  to  render  such  constitution  unsusceptible 
of  a  disease  from  a  given  different  morbid  poison,  and  yet  such  constitution  shall  remain  susceptible  of  the 
former  disease,  from  tlie  former  morbid  poison.  Hence,  I  apprehend,  tlie  only  just  ground  of  objection 
which  may  be  taken,  is  that  of  the  observations  on  the  authority  of  which  the  fact  is  said  to  be  established, 
Let  us  then  state  the  evidence. 

Under  Case  ix.  p.  21,  Dr.  Jenuer  relates  the  history  of  a  person  who  was  first  affected  with  the  cow-pox 
in  the  year  1780,  a  second  time  in  1791,  and  a  third  time  in  1794.  “The  disease  was  equally  severe  the  second 
and  third  time  as  it  was  tlie  first,”  which  is,  in  general,  other  wise  both  in  the  brute  and  human  kind.  Inoc¬ 
ulation  of  the  variolous  poison  was  twice  instituted  in  this  patie  t,  but  without  producing  disease,  nor 
could  the  patient  be  infected  by  association  with  persons  laboring  under  tlie  small-pox. 

Another  patient  (see  Jenner,  p  51.)  suffered  the  cow-pox  in  1759;  in  1797  he  was  inoculated  with  the 
variolous  poison,  but  without  exciting  the  disease,  In  1798  the  cow-pox  again  took  place 

With  respect  to  the  information  which  I  have  gained  by  my  inquiries,  concerning  this  fact;  some  of  my 
correspondents  observed,  that  the  cow-pox  occurred  so  seldom  among  the  human  kind,  that  they  had  no 
observations  to  determine,  whether  a  person  could  undergo  tlie  disease  more  than  once  ;  tlie  greater  part  of 
my  correspondents  ventured  to  say,  that  it  had  never  been  seen  more  then  once  in  the  same  person  ;  but 
some  testified  that  the  cow-pox  certainly  does  take  place,  repeatedly,  in  the  same  constitution. 

Mr.  Woodman,  of  Aylesbury,*  says,  “the  cow-pox  does  not  supersede  itself  ou  future  occasions,  for  that 
cow-boys  have  it  repeatedly.” 

It  may  be  worth  while  to  notice,  that  none  of  the  gentlemen  of  whom  I  made  inquiries,  knew  an  instance 
of  the  disease  attacking  the  same  cow  more  than  once  ;  and  it  was  said  that  it  was  the  current  opinion 
that  this  was  a  fact. 

The  evidence  for  this  fact,  to  my  apprehension,  only  proves,  satisfactorily,  that  the  local  affection  of  the 
cow-pox  may  occur  in  the  same  person  more  than  once  ;  but  whether  the  peculiar  fever  also  occurs  more 
than  once  in  the  same  person,  from  the  cow-pox  poison,  does  not  appear  certain;  and  must  be  determined 
by  future  observations,  to  be  made  with  a  particular  view  to  this  point.  Future  observations  must  likewise 
determine,  whether,  in  those  cases,  (if  such  occur)  in  which  a  person,  after  having  gone  through  the  cow- 
pox,  takes  the  small-pox  the  cow-pox  was  attended  with  the  fever,  or  was  merely  a  local  affection.  It  seems 
pretty  well  ascertained,  that  the  variolous  poison  may  produce  tlie  small  pox  only  locally,  or  without  any 
affection  of  the  constitution  ;  and  in  such  a  case,  the  constitution  is  still  susceptible  of  the  small-pox,  and 
yet.  in  both  cases,  viz:  of  the  local  affection  only,  and  of  the  whole  constitution,  the  matter  of  the  eruptions 
is  capable  of  infecting  others,  so  as  to  produce  the  sm.dl  pox  ;  either  locally  only,  or  also  in  tlie  whole  con¬ 
stitution  .  Hence  it  seems  probable,  that  similar  local  ami  general  effects  may  be  produced  by  the  cow-pox 
poison,  and  not  only  in  the  humankind,  but  iu  cows.  I  acknowledge,  however,  that  the  case,  p  51.  in 
Jenner’s  book,  militates  against  this  supposition. 

V.  A  person  is  susceptible  of  the  cow-pox,  who  hue  antecedently  been  affected  with 
the  small-pox. 


See  Mr.  Smith’s  Letter,  above  cited. 


76 


Cow-Pox;  George  Pearson,  M.  I). 


Dr.  tTetmer.,  pp.  15-19,  gives  some  instances  of  persons  taking  the  cow-pox  who  had  certainly  gone 
through  the  small-pox.  But  he  says,  “  It  is  a  fact  so  well  known  among  our  dairy  farmers,  that  those  who 
have  had  the  small-pox  either  escape  the  cow-pox  or  are  disposed  to  have  it  slightly  :  that  as  soon  as  the 
complaint  shows  itself  among  the  cattle,  assistants  are  procured,  if  possible,  who  arc  thus  rendered  less 
susceptible  of  it,  otherwise  the  business  of  the  farm  could  scarcely  go  forward.” 

I  have  not  got  much  additional  information  on  this  fact.  It  seems,  however,  sufficiently  authenticated 
that  people  may  have  the  cow-pox  after  they  have  had  the  small-pox,  hut  it  will  require  more  nice  attention 
to  satisfy  the  query  whether,  ni  such  cases,  the  cow-pox  affects  the  whole  constitution  or  is  only  a  local 
affection  ? 

Mr.  Dowue*.  in  particular,  speaks  of  a  family  who  did  not  take  the  cow-pox  when  much  exposed  to  lbe 
infliction,  because  they  had  all  gone  through  the  small-pox,  except  one  who  had  been  afflicted  already  with 
the  cow-pox.  I  met  with  a  servant  at  Mr.  Rhodes’  farm,  on  the  Hampstead  Road,  who  attested  that  he  bad 
suffered  the  cow-pox  fourteen  years  ago,  hut  that  long  before  that  time  he  had  gone  through  the  small-pox: 

Professor  Wall!  says:  “  The  answer  to  the  question  whether  a  person  is  capable  of  taking  the  cow-pox 
who  has  gone  through  the  small-pox,  is  of  some  decidedly  that  such  a  person  is  not  liable  to  the  infection  of 
the  cow-pox.  Others  of  equal  experience  have  answered  this  question  with  doubt.” 

At  Mr.  Rhodes’  farm,  at  Islington,  1  found  that  one  of  the  male  servants  who  had  been  long  employed  in 
taking  care  of  milk  cows  in  the  environs  of  London,  distinguished  t lie  cow-pox  very  clearly  from  common 
inflammation  of  the  teats  with  scabs,  with  which  several  cows  were  at  the  time  that  I  saw  this  man 
affected.  He  had  never  contracted  the  cow-pox,  although  lie  had  been  repeatedly  exposed  to- the  infection, 
and  when  others  took  it.  He  was  deeply  pitted  with  the  small-pox,  which  he  labored  under  when  a  young 
child. 

VI.  The  cow-pox  is  not  communicated  in  the  state  of  effluvia  or  gas,  nor  by  adhering 
to  the  skin  in  an  irnperoeptably  small  quantity,  nor  scarce,  unless  it  he  applied  to  di¬ 
visions  of  the  skin  by  abrasions,  punctures,  wounds,  etc. 

Some  morbific  poisons  are  communicated  to  animals  only  in  (he  state  of  invisible  effluvia  or  gas,  e.  g.  Ihe 
miasmata  which  produced  intermittent  fevers  :  the  contagion  which  produces  the  ulcerous  sore  throat,  that 
which  occasions  the  whooping-cough,  the  measles,  etc.  Other  morbific  poisons  are  communicated  both  in 
the  state  of  effluvia  and  in  a  palpable  or  visible  quantity,  e.  g.  the  variolous  poison,  the  matter  which  pro¬ 
duces  in  oxen,  the  murrain  or  loose  bo  villa,  etc.  Others  again  arc  not  propagated  in  the  state  of  effluvia  or 
gas,  but  in  a  palpable  or  visible  quantity  only,  as  the  hydrophobic  poison,  the  syphilitic,  etc.,  and  to  these 
last  must  now  be  added  the  morbific  poison  of  the  cow-pox. 

It  does  not  appear  that  the  disease  spreads  from  any  infected  cow  among  other  cows  which  are  fed  in 
the  sa-mt?  stable  like  a  contagious  disease,  Persons  who  sleep  in  the  same  bed  with  one  who  is  laboring 
with  the  cow-pox  are  not  in  this  way  liable  to  be  infected.  (See  Jenner,  pp.  68,  69.)  It  is  not  even  propa¬ 
gated  from  the  cows  to  the  milkers  i'or  the  most  part,  unless  the  skiu  of  the.  part  of  the  hands  to  which  the 
matter  is  applied  he  divided . 

This  property  of  the  cow-pox  infection  not  being  propagated  so  as  to  produce  disease,  but  by  contact' 
and  then  only  when  applied  in  a  palpable  or  visible  quantity,  and  also  scarce  unless  the  skin  be  divided,  is 
the  most  important,  one.  Yet  a  few  instances  I  apprehend  will  suffice  to  show  clearly  pnder  what  circum¬ 
stances  the  cow-pox  infliction  produces  disease. 

A  boy  who  was  inoculated  for  the  cow-pox  slept,,  while  ho  was  laboring  under  the  disease,  with  two 
other  boys,  but  neither  of  them  by  this  exposure  to  the  affliction  got  the  cow-pox.  A  young  woman  who 
had  the  cow-pox,  with  several  sores,  which  maturated  to  a  great  extent,  slept  in  the  same  bed  with  a  fellow 
dairy  maid  who  never  had  been  inflicted  either  with  the  cow-pox  or  small-pox,  hut  the  disease  was  not 
communicated.  A  young  woman,  on  whose  hands  were  several  large  suppurations  from  the  cow-pox.  was 
a  daily  nurse  fo  an  infant,  hut  the  infant  was  uninfected.  (See  Jenner,  pp.  68-69.) 

I  am  instructed  uniformly  by  my  correspondents  that,  the  cow-pox  arises  only  from  matter  evidently  ap¬ 
plied  most  Irequently  bv  friction  of  the  diseased  teats  in  milking,  but  sometimes  from  the  matter  lodging 
accidentally  in  some  soft  part,  yet  even  under  the  circumstance  it  frequently  fails  to  infect  unless  there  he 
a  cut,  scratch,. puncture,  etc.,  of  the  hands. 

Mr.  Drewe  mentions  the  instance  of  a  woman  who  lost,  her  eyesight  in  consequence  of  the  infectious 
matter  being  heedlessly  applied  to  the  eye,  and  that  the  cow-pox  has  been  observed  to  take  place  from 
handling  the  milk  pail  on  which  the  infectious  matter  has  been  incautiously  allowed  to  remain . 

VII.  The  local  affection  in  the  cow-pox  produced  in  the  casual  way  is  generally  more 
severe  and  of  longer  duration  than  usually  happens  in  the  local  afflictions  in  the  inocu¬ 
lated  small-pox,  but  in  the  cow-pox  tlie  fever  is  in  no  case  attended  with  symptoms 
which  denote  danger,  nor  has  it  in  any  instance  been  known  to  prove  mortal. 

The  cow-pox  in  the  incidental  way,  for  sufficient.lv  obvious  reasons,  most  commonly  affects  the  palms  of 
the  hands  There  is  a  wide  difference  in  the  degree  of  a  local  affection.  I  am  instructed  by  my  communi¬ 
cations  that  the  extreme  cases  are,  firstly,  those  in  which  the  patients  are  inflicted  with  so  much  painful 
inflammation  as  to  b^  confined  to  their  beds  for  several  days,  and  have  painful  phagedenic  sores  for  several 
months.  Secondly,  those  cases  which  are  so  slight  that  the  patients  are  not  confined  at  all,  hut,  get  well  in 
a  week  or  ten  days.  In  the  more  severe  cases,  in  which  the  inflamed  spots  become  vesicular  with  edges  of 
the  pustules  more  elevated  than  the  cuticle,  and  of  a  bluish  or  a  purple,  color  there  are  pains  of  the  axilla, 
fever  and  now  and  then  a  little'delirium . 

These  symptoms  continue  fiom  one  to  three  or  four  days,  leaving  ulcerated  sores  about  the  hands,  which, 
from  the  sensibility  of  the  parts,  are  very  troublesome,  and  commonly  heal  slowly,  frequently  becoming 
phagedenic,  like  those  from  which  they  sprung.  The  lips,  nostrils,  eyelids  and  other  parts  of  the  body  are 
sometimes  affected  with  sores,  hut  these  evidently  arise  from  their  being  heedlessly  rubbed  or  scratched 
with  the  patient’s  inflicted  lingers.  Dr.  Jenner  considers  the  bluish  or  livid  tint  of  the  pustules  to  he 
characteristic  of  the  cow-pox.  P.  5. 

Mr  Drewe’s  information  on  the  fact  is,  “  That  the  symptoms  are  similar  to  the.  small-pox,  hut  less  violent- 
The  pustules  are  only  about  the  hands,  in  the  parts  which  have  been  in  contact,  with  the  infected  teats.” 


'Mr.  Downe’s  letter  of  August  dO. 
t Letter  of  Professor  Wall,  aboTO 


Cow-Pox;  Georye  Pearson ,  M.  I). 


i  i 


But  in  answer  to  the  question  whether  on  the  whole  the  cow-pox  is  a  disease  of  less  magnitude  than  the 
small-pox  by  inoculation,  he  says  :  “  When  I  consider  what  a  slight  disorder  the  inoculated  small-pox  is. 

it  will  not,  in  my  humble  opinion,  admit  of  comparison,” 

Mr'.  Bolling  says:  “  There  is  a  swelling  under  the  arm.  chilly  tits,  etc. ,  not  different  from  symptoms  of 
the  breeding  of  the  small-pox.  After  the  usual  time  of  sickening,  namely,  two  or  three  days,  there  is  a 
large  ulcer,  not  unlike  a  carbuncle,  which  discharges  matter.” 

Dr.  Pulteney’s  account  of  the  symptoms  is  in  these  terms:  “A  soreness  and  swelling  of  the  axillary 
glands  as  under  inoculation  for  the  small-pox,  then  chilliness  and  rigors  and  fevers  as  in  the  small-pox. 
Two  or  three  days  afierwaids,  abscesses,  not  unlik,  carbuncles,  appear  generally  on  the  hands  and  arms 
which  ulcerate  and  discharge  mneh  matter.” 

Mr.  Downe,  speaking  to  this  point,  says  :  “  The  symptoms,  as  far  as  could  be  ascertained  in  the  cow 

pox.  were  similar  to  these  of  the  small-pox,  but  I  never  heard  of  any  who  had  them  in  any  degree  alarm¬ 
ing.”  Again,  ,l  the  symptoms  are  exactly  similar  to  those  of  the  small-pox  by  inoculation,  when  of  the  most 
favorable  kind.  The  disease  generally  disappears  in  about  the  same  time  that  the  small-pox  does." 

Mr.  Giffard  tells  me  that  “  he  never  heard  of  either  men  or  cows  dying  of  the  cow-pox.” 

Mr.  Woodman  (see  Mr.  Smith's  letter)  testifies  that  he  never  observed  symptoms  worthy  to  be  called 
fever;  there  was  merely  “feverish  heat  when  the  pain  was  considerable.” 

I)r.  DePalis  observes  that  one  of  the  persons  affected  with  the  cow-pox  “was  much  struck  witli  the  re¬ 
semblance  to  the  symptoms  he  had  lately  experienced  in  the  small -pox.” 

Professor  Wall's  information  is  that  “the  milkers  have  the  disorder  only  once,  generally  with  preceding 
fever,  sometimes  very  violent,  sometimes  more  mild.”  “No  human  creature,  or  cow,  has  been  known  to  be 
in  danger,  or  to  die  of  the  cow-pox.”  After  a  strict  inquiry  at  the  milk  farms  adjoining  to  London,  I  could 
not  find  that  any  person  had  died  of  the  cow-pox. 

With  respect  to  the  animals  from  which  the  human  creature  derives  the  disease,  it  is  known  only  to  effect 
cows.  They  have,  sometimes,  but  it  is  very  seldom  observed,  a  disorder  of  the  whole  constituiion,  "the 
secretion  of  milk  being  much  lessened.”  The  local  affection  appears  w  ith  irregular  pustules  on  the  nip¬ 
ples.  “At  their  first  appearance  they  are  commonly  ot  a  palish  blue,  or,  rather,  of  a  color  somewhat  ap¬ 
proaching  livid,  and  are  surrounded  by  an  erysipelas  inflammation.  These  pustules,  unless  a  timely  rein 
edv  be  applied,  frequently  degenerate  into  phagedenic  ulcers,  which  prove  extremely  troublesome.  (See 
Jenner,  pp.  3  and  4.) 

Dr.  Pulteney  acquaints  us,  that  “  the  disease  makes  its  appearance  on  the  udder  of  the  cow,  and  affects 
the  teats  principally,  which  inflame,  then  ulcerate,  discharging  a  bloody  matter;  but  it  does  not  appear  that 
the  disease  is  more  local,  as  the  co-ws  seem  not  to  be  out  of  health  in  other  respects.'.’ 

From  Dr.  Drewe’s  testimony,  however,  it  appeal’s  that  the  whole  constitution  of  the  cow  is  affected- 
Tnere  being  “loss  of  appetite  and  of  milk,”  as  well  as  “  ulcerated  teats,”  so  as  to  render  the  animal,  in 
some  cases,  totally  unfit  for  the  dairy.  “  It  is  infectious  in  the  herd,  and  the  infection  is  probably  con¬ 
veyed  by  the  person’s  bands  that  milks  them.” 

Mr.  Downers  information,  relating  to  the  present  part  of  our  inquiry,  is  Unit  “the  only  symptoms  were 
eruptions  about  the  teats  of  the  cow,  exactly  similar  to  the  small-pox,  which  gradually  become  sore,  and 
fall  off;  and  the  infection  was  soon  communicated  to  a  whole  dairy,  as  was  supposed  by  t lie  hand  of  the 
peisou  who  milked.  The  animals  suffered  much  in  the  operation  of  milking.” 

Professor  Wall  mentions  that  the  symptoms  are  “blue  or  livid  blotches  on  the  teats  and  udder,  painful 
an'd  suppurating.  The  cows  are  seldom  ill,  so  as  to  refuse  their  food  Others  observe,  that  cows  being 
naturally  disposed  to  a  lax  habit  of  body,  are  not  so  much  afilicted  with  feverish  symptoms.  Some  say 
cows  suffer  no  fever  at  all.” 

The  testimony  of  several  other  correspondents  have  been  already  stated,  that  a  cow  has  never  been 
knowTn  to  die  of  the  cow-pox ;  to  which  I  add  in  confirmation,  that  of  the  milk  farmers  near  London. 

VIII.  No  consequential  disease,  which  should  be  attributed  to  the  cow-pox  has  been 
observed ;  nor  has  any  disease  been  excited,  to  which  there  previously  existed  a  disposi¬ 
tion  ;  nor  has  it  been  discovered  to  produce  a  predisposition  to  particular  diseases. 

Although  a  considerable  body  of  evidence  might  be  stated  in  confirmation  of  these  momentous  facts,  from 
the  experience  of  Dr.  Jenner,  and  the  uniform  testimony  of  my  correspondent ;  and  although  we  should 
be  inclined  to  conclude  in  favor  of  these  facts,  from  the  consideration  of  the  m  ture  of  the  cow-pox,  as  far 
as  yet  known,  yet  it  does  not.  appear  to  my  judgment  that  the  observations  and  arguments  warrant  more 
than  conclusions  on  the  side  of  great  probability.  A  number  of  persons,  many  hundreds,  have  gone 
through  the  inoculated  small-pox;  yet  no  one  doubts  that,  in  a  certain  proportion  of.  instances,  disease  has 
been  excited  and  disposition  to  disease  been  produced. 

We  are  led  then  to  think  that  a  greater  number,  and  more  accurate  observations  are  wanting,  to  author¬ 
ize  positive  conclusions  relating  to  the  facts  stated  under  this  VIII  head, 

IX.  The  cow-pox  infection  may  produce  the  peculiar  local  disease  belonging  to  it,  hut 
without  the  difference  of  the  constitution  ;  in  which  case,  the  constitution  is  liable  to  he 
infected  by  the  small-pox  infection. 

’[  bis  fact  is  not  of  small  consequence  either  in  respect  of  general  pathology  or  practice.  Dr  Jenner  s 
work,  p  71,  furnishes  us  with  an  unequivocal  example  of  this  fact.  A,  woman  was  affected  with  the 
local  disease  of  the  cow-pox  in  the  ordinary  way,  but  without  any  pains  or  swelling  of  the  axilla,  or  any 
disorder  of  the  whole  constitution,  this  person  was  subsequently  afflicted  by  the  smallpox;  but  a  fellow - 
servant  who  had  suffered  witli  the  cow  pox,  (at  the  same  time  and  from  the  same  source  <>t  infectious 
matter,)  in  which  there  was  fever  as  well  as  local  disease,  could  not  be  infected  by  inserting  the  small-pox 
poison;  even  repeated  trials  for  this  purpose  wore  successless.  Hence,  they  who  offer  as  evidence  in¬ 
stances  of  persons  taking  the  small  pox  after  they  have  gone  through  the  cow-pox,  will  do  well  to  assure 
themselves  that  the  whole  constitution  was  affected  in  the  cow-pox,  otherwise  such  evidence  will  he  inad¬ 
missible.  Analogous  facts  have  been  ascertained,  on  good  authority  in  the  small  pox,  although  the  in-i 
stances  are  too  scarce  to  afford  too  scrupulous  minds  full  proof.  It  has  been  found  that  the  usual  loca 


78 


Cow-Pox  ;  George  Pearson ,  M.  I). 


disease  of  tlie  inoculated  small  pox  may  occur,  unattended  by  a  disorder  of  the  whole  constitution  ;  but  yet 
the  matter  of  such  local  small  pox  will,  in  other  persons,  produce  not  only  the  local  disease,  but  general 
eruption  and  fever;  and  that  the  person  wlio  had  undergone  this  local  small-pox  only,  will  be  infected  at  a 
future  time,  so  as  to  have  both  the  ordinary  local  disease  and  lever  of  the  small-pox  with  eruptions.  ■ 

It  appears  from  the  observations  of  Dr.  .Tenner,  page  50,  Mr,  Drewe,  Dr.  Pulteney,  and  others,  that  during 
the  cow-pox  in  the  human  subject,  inflammation  and  sores  are  apt  to  be  excited  by  the  matter  being  lodged 
upon  various  parts,  especially  if  the  skin  be  divided ;  but  no  mention  is  made  of  fresh  fever  being  excited, 
nor  of  the  peculiar  livid  and  bluish  tint  of  the  cow-pox  pustulous  sores.  Enough  has  been  said  in  a  preced¬ 
ing  part  of  this  panel-  to  direct  observers  in  future  to  ascertain  more  accurately  the  effects  of  the  agency  of 
the  cow-pox  infection  on  the  whole  constitution,  and  on  part  of  it  only. 

It  will  be  necessary  also  to  caution  inquirers  against  the  errors  of  admitting  facts  to  belong  to  the  cow- 
pox,  as  understood  in  this  paper,  which,  in  reality,  belong  to  thecliicken-pox,  or  swine-pox,  in  some 
provincial  situations,  are  designated  by  the  name  of  the  cow-pox, 

Yet  another  caution  is  necessary  in  investigating  the  truth,  namely,  to  distinguish  from  the  cow-pox, 
“  the  pustulous  sores  which  appear  spontaneously  on  the  nipples  of  the  cows  ;  and  instances  have  occurred, 
although  very  rarely,  of  the  hands  of  the  servants  employed  in  milking  being  affected  with  sores  in  conse¬ 
quence.  and  even  of  their  feeling  an  indisposition  from  absorption.  These  pustules  are  of  a  much  milder 
nature  than  those  which  arise  from  that  contagion,  which  constitutes  the  true  cow-pox.  They  are  always 
free  from  the  bluish  or  livid  tint  so  conspicuous  in  the  pustules  in  that  disease.  No  erysipelas  attends 
them,  nor  do  they  show  any  phagedenic  disposition,  as  in  the  other  case  ;  but  quickly  terminate  in  a  scab, 
without  creating  any  apparent  disorder  in  the  cow.”  Like  the  cow-pox,  “this  eruption  appears  most  com¬ 
monly  in  the  spring,  when  the  cows  are  flrst  taken  from  their  winter  food,  and  fed  with  grass.  Jenner,  p.  7. 

I  observed  during  my  visits  to  the  cow  stables  near  London,  in  August  and  September  last,  that  a  num¬ 
ber  of  cows  were  infected  with  eruptions,  sores  and  scabs  on  their  breasts,  especially  on  their  paps.  None 
of  the  animals  had  any  constitutional  affection,  nor  could  T  learn  that  any  of  the  milkers  were  infected 
The  eruptions  now  spoken  of  break  out,  as  I  was  told,  espceialh  in  new  comers.  Fresh  cows,  it  was  said, 
were  apt  to  be  thus  affected,  on  account  of  the  much  richer  food  which  is  given  in  London  than  in  the 
country.  The  same  kind  of  sores,  eruptions  and  scabs  (which  must  be  distinguished  from  the  cow-pox),  I 
apprehend  are  common  in  the  country  ;  of  which  the  following  testimonials  will  be  useful. 

Sir  Isaac  Pennington,  who  could  not  learn  that  the  cow-pox  was  prevalent  in  Cambridgeshire,  says,  “I 
find  cows  are  liable  to  inflammation  of  the  udders,  but  they  do  not  affect  the  hands  of  the  milkers.” 

A  number  of  milch  cows  are  kept  near  Twickenham,  and  the  Beauchamp* * * §  surgeon  gave  himself  much 
trouble  to  oblige  me.  by  making  inquiries  according  to  the  direction  of  my  queries.  He  instructs  me, 
“that  all  the  cow-keepers  agree  that  warts,  and  small  bladders,  or  pustules,  appear  frequently  on  the  teats 
of  the  cow,  but.  never  observed  the  animal,  or  the  milkers,  to  be  affected,  not  even  when  these  pustules 
were  burst  by  the  hands  of  milkers  who  had  never  suffered  the  small  pox. 

Dr.  Beckwith,  of  York,  who  well  merits  my  best  thanks,  bestowed  great  pains  in  making  inquiries 
among  the  medical  practitioners  in  his  neighborhood,  and  the  farmers.  His  report  is,  -  ‘It  am  well  satisfied 
that  no  such  disease  as  the  cow-pox  has  ever  appeared  here  in  the  memory  of  man  ;  but  soreness  and  chops 
of  the  naps  are  observed,  from  distension  by  milk  in  summer,  never  in  winter,  without  affecting  the  bauds 
of  milkers.” 

Tn  the  Pestes  bovilla,  or  murrain,  the  breasts,  and  especially  the  paps,  are  sometimes  affected  with  pus¬ 
tules,  or  tubercles^;  which,  however,  seem  to  be  in  that  disease  the  least  of  the  unfavourable  symptoms. 

Dr.  Belcombe,  of  Scarborough,  in  his  obliging  letter,  observes,  ||  “there  is  a  disease  of  the  paps,  which 
renders  t-Imm  exceedingly  sore  and  difficult  to  milk,  but  it  is  not  infectious,  and  the  same  cow  has  it  many 
times ;  nor  are  the  hands  of  the  milkers  ever  sore  from  it.  It  commonly  happens  in  hot  and  wet  summers.” 

On  considering  the  facts  of  the  preceding  history,  it  appears  that  some  useful  conclusions  ot  a  practical 
kind  may  be  drawn  from  them. 

I.  Tiie  body  of  evidence  is  numerous  and  respectable,  declaring  that  a  person  who 
lias  labored  under  the  cow-pox  fever,  and  local  eruption,  is  not  susceptible  to  the  small¬ 
pox.  It  does  not  appear  that  a  single  well  authenticated  contravening  instance  lias 
fallen  under  observation.  But.  I  do  not  apprehend  that  accurate  and  able  reasoners  will 
consider  the  fact  as  completely  established;  though  I  doubt  not  they  will  allow  that  the 
testimonies  now  produced  greatly  confirm  the  probability ;  and  that  the  cautious  appro¬ 
priation  of  it,  in  practice,  is  warrantable. 

In  the  present  inquiry  the  attestations  have  been  obtained  from  so  many  persons,  that 
it  seems  highly  improbable,  indeed,  that  the  contrary  instances  should  have  been  unob¬ 
served,  or  purposely  kept  out  of  sight.  If  the  fact  had  been  supported  by  the  testimony 
of  one  observer  only,  the  experience  of  the  world  would  have  justified  us  in  demanding 
the  account  of  the  failures;  after  the  example  of  the  keen  skeptic  of  old,  who,  on  being 
shown  the  native  tablets  of  those  who  had  been  preserved  from  shipwreck,  instead  of 
yielding  his  assent,  replied,  14  Where  are  the  tablets  of  those  who  have  perished  ?”  $ 


*  Mr.  Beauchamp’s  Letter,  Trickenliam,  Sept.  18,  1798. 

t  Dr.  Beckwith’s  Letter,  York,  Sept.  19,  1798. 

1  Illos  duntaxat  lioves,  and  quidem  admodum  raros,  mortem  effugitt'e  quibus  abscessus  ac  decubitus 
informam  tuberculorurn,  scabici.  depilationis,  vel  rliagadum,  in  uberum  papillis  fieri  contegerit. — Lancisi 
de  bovilla  peste,  png.  9,  tom.  2,  No.  134. 

||  Dr.  Belcome  Letter.  Scarborough,  Sept.  22,  1798. 

§  Intellectus  humanusin  iis  quie  semel  plaenerunt  (ant  quia  recepta  font  et  credita,  ant  quia  delectant) 
alia  etiam  omnia  traliit  ad  snffragatioiiem  et  consensum  cum  illis.  Et  licet  major  sit  instantiarnm  vis  et 
c.ipia  quas  occurrunt  in  contrarinm  ;  tamer  eas  aut  non  obxervat  ant  contemuit,  ant  distinguendc  summovit 
ft  rejicit,  non  sine  magno  etperniciosopnejudicio  quo  prioribus  illis  syllepsibus  autlioritas  nianoat  inviolata. 
Itaqiio  recto  respondit,  qui,  cum  suspensa  tabula  in  templo  ei  manstraretur  eorum,  qni  vota  solverant,  quod 
naufragii  periculo  elapsi  sint,  atque  interrogando  premeretur,  anne  turn  quidem  eorum  numcn  agnosceret, 
quaisivit  denuo ;  At  vbi\mnt  illi  depicti  qui  post  vota  nuncupata  perierunt  'l — Yerulamii  Novum  Organum, 
Aphor.  XL VI. 


79 


Cow-Pox ;  George  Pearson ,  M.  D. 


Granting  the  truth  of  this  fact,  its  usefulness  in  practice,  in  contemplation  of  it  as  a 
substitute  of  the  small-pox,  must  depend  upon  the  effects  of  the  cow-pox,  in  comparison 
wit  h  the  small-pox,  especially  in  the  particulars  of  the  degree  of  danger  to  life  ;  the  kind 
of  symptoms  and  their  duration  ;  and  the  subsequent  effects  on  the  constitution. 

1st.  The  evidences,  showing  that  no  one  has  ever  died,  or  even  been  apparently  in  . 
danger,  are  the  same,  as  those  for  the  fact  itself;  that  a  person  is  not  susceptible  of  the 
small-pox  after  having  suffered  the  cow-pox.  But  the  conclusion,  with  respect  to  the 
point  of  danger,  is  far  more  equivocal.  The  comparison  for  this  purpose  should  be  made 
with  not  fewer  than  one,  or  even  two  thousand  instances.  For,  though  in  several' 
hundred  examples  of  the  cow-pox,  which  have  been  under  observation,  not  one  person 
has  fallen  a  victim  ;  this  might,  and  indeed  has  been,  the  fortunate  issue  of  the  inocu¬ 
lated  small-pox,  of  which  it  will  suffice  to  give  two  instances. 

Dr.  William  Heberden  informs  me,  that  at  Hungerford,  a  few  years  ago,  in  the  month  of 
October,  800  poor  persons  were  inoculated  for  the  small- pox,  without  a  single  case  of  death. 
No  exclusion  was  made  on  account  of  age,  health,  or  any  other  circumstance,  but  preg¬ 
nancy  ;  one  patient  was  80  years  of  age ;  and  many  were  at  the  breast,  and  in  the  state 
of  toothing. 

Dr.  Woodville  acquaints  me,  that  in  the  current  year,  from  January  to  August  inclu¬ 
sive,  out  of  upwards  of  1700  patients  inoculated  at  the  Inoculation  Hospital,  including 
the  in  and  out  patients,  only  two  died,  both  of  whom  were  of  the  latter  description. 

Such  instances  of  success  can  only  be  attributed  to  a  certain  favorable  epidemic  state 
of  the  human  constitution  itself,  existing  at  particular  times;  for  the  proporlion  of 
deaths  is  usually  much  greater  ;  indeed,  sometimes  it  is  very  considerably  greater,  owing, 
probably,  to  certain  unfavorable  epidemic  states.  Of  the  various  different  estimates 
which  have  been  made,  the  fairest  seems  to  be  that  which  states  (under  a  choice  of  the 
most  favorable  known  circumstances  which  can  be  commanded)  one  death  out  of  two 
hundred  inoculated  persons.  But  when  it  is  considered  that  we  are  not  to  make  the 
comparison  between  the  iuoculated  small-pox,  and  what  may  be  called  the  natural  cow- 
pox;  when  it  is  considered  that  the  inoculated  cow-pox,  in  respect  of  the  local  eruption 
and  ulceration,  is  a  much  less  painful  and  shorter  disease  than  the  natural,  or  casual 
cow-pox;  when  it  is  considered  that  the  inoculated  small-pox  is  especially  dangerous 
from  the  number  of  eruptions,  and  that  there  is  only  a  trilling  local  eruption  of  the  part 
poisoned  in  the  iuoculated  cow-pox  ;  when  it  is  considered  that  the  cow-pox  infection  is 
not  propagated  iu  the  state  of  effluvia.  I  say,  from  such  considerations,  it  seems  to  be 
most  reasonable  to  conclude,  that  that  there  is  great  probability  of  the  cow-pox  either  not 
proving  fatal  at  all,  or  at  most  being  much  less  frequently  so  than  the  iuoculated  small-pox. 

Further:  the  comparison  of  the  two  diseases  should  be  instituted,  with  respect  to 
danger,  under  the  particular  circumstances  of  Pregnancy  ;  Age  toothing;  Peculiar  morbid 
states ;  Peculiar  healthy  states,  or  Idiosyncracies ;  and  certain  seasons  or  epidemical  states. 

Pregnancy.  The  inoculated  small-pox  is  so  commonly  mortal  to  the  unborn  in  every  pe¬ 
riod  of  gestation  ;  and  so  frequently  so  likewise  to  the  mother  in  advanced  states  of  ges¬ 
tation;  that  no  prudent  practitioner  would  choose  to  inoculate  under  these  circum¬ 
stances  ;  but  to  escape  the  taking  the  disease  by  effluvia,  in  t  he  casual  way.*  The  expo¬ 
sure  to  infection,  being  sometimes  unavoidable,  I  confess  I  feel  anxious  to  ascertain  the 
effects  of  inoculating  the  cow-pox  infection  in  such  persons.  And  on  the  grounds  of  the 
slightness  and  short  duration  nf  the  cowpox  eruptive  fever  and  of  the  merely  local  erup¬ 
tion.  I -apprehend  a  practitioner  would  be  justifiable  in  preferring  the  inoculation  of  the 
infection  of  this  distemper  to  that  of  the  small-pox. 

On  another  account,  the  practice  of  inoculating  the  cow-pox  seems  recommendable  in 
pregnancy,  namely,  that  of  preventing  the  irritable  state  of  the  womb,  which  is  produced 
by  abortion,  during  the  small-pox.  From  which  irritable  state,  the  female  will  be  very 
liable,  in  future,  to  the  misfortune  of  abortions.  This  is  so  notorious  a  fact  in  brutes,  that 
a  cow  which  has  suffered  abortion,  while  laboring  under  the  Lues  bovilla,  or  murrain, 
will  seldom,  in  future,  bring  forth  a  live  calf;  and  on  this  account  such  cow  becomes 
greatly  degraded  in  value.  Whereas  a  cow,  which  has  had  the  inoculated  murrain  when 
a  calf,  or  at  least  before  she  was  impregnated,  is  thereby  greatly  enhanced  in  value.  It 
was  the  great  Camper  who  recommended  to  his  countrymen  in  Holland  the  general  inoc¬ 
ulation  of  calves  for  the  murrain.  The  matter  is  most  advantageously  inserted  into  the 
ear,  tail  or  dewlap. 

Dr.  Layard  says,  oxen  may  be  inoculated,  either  with  the  pus  of  their  eruptions,  or 
with  the  mucus  from  the  nose  ;  and  that  few,  comparatively  with  the  casual  disease,  die. 
Oxen  were  not  infected  by  eating  matter  of  the  pustules  with  their  corn  ;  not  by  cover¬ 
ing  their  heads  with  a  cloth,  which  had  been  impregnated  with  steam  from  the  breathing 
of  infected  oxen. 

Whether  the  unborn  animal  will  take  the  infection  of  the  cow-pox  from  the  mother, 
is  a  question  for  future  observation  to  determine. 

*  See  my  paper  On  the  effects  of  the  variolous  infection  on  pregnant  women. — Medical  Annals,  Vol.  IX, 
Decade  2d,  1795. 


80 


Cow-Pox ;  George  Pearson ,  M.  J). 


It  lias  been  fully  determined  antecedently  to  the  recent  controversy  between  two  emi¬ 
nent  anatomists  for  the  honor  of  the  discovery,  by  pathological  observations,  and  demon¬ 
strated  bv  anatomical*  experiment  and  artifices,  that  the  blood  of  the  mother  does  not 
pass  to  the  foetus,  nor  leturn  from  the  foetus  to  the  mother,  for  the  unborn  frequently 
escapes  the  disease  of  the  smallpox,  although  the  mother  be  affected  with  it;  and  when 
the  foetus  is  infected,  it  is  uniformly  subsequent  to  the  eruption,  and  even  to  suppura¬ 
tion  of  the  pustules  on  the  mother.!  Further  injections  will  pass  from  the  umbilical 
arteries  of  the  foetus  into  its  body,  and  return  by  the  umbilical  vein,  provided  the  pla¬ 
centa,  or  ricarious  lungs  ot  the  foetus  be  entire.  The  foetus  then  does  not  receive  its 
blood  from  the  mother,  nor  does  the  blood  of  the  foetus  circulate  through  the  mother. 
Yet  the  infant,  before  birth,  frequently  does  receive  some  kinds  of  infectious  matter 
from  the  mother,  viz:  the  syphilitic,  variolous,  etc.,  and  of  consequence  it  seems. possi¬ 
ble  that  it  may  receive  the  cow-pox  infection  to  its  formation  by  the  mother’s  constitu¬ 
tion.  In  this  case, we  should  expect  no  local  disease,  but  merely  the  specific  fever. 

Aye.  Whatever  doubts  may  be  entertained  of  very  advanced  or  decrepit  age  being  ad¬ 
verse  to  the  success  of  the  inoculated  small-pox,  I  am  sure  that  I  shall  be  supported  by 
tbe/ipinion  and  practice  of  a  ve^y  decisive  majority  that  infancy  is  the  state  in  which 
the  largest  proportion  die  under  inoculation.  In  medical  families,  and  in  large  towns, 
where,  to  the  reproach  of  our  police,  persons  labouring  under  the  small-pox  are  suffered 
to  appear  in  the  streets  and  public  walks;  even  the  most  cautions  practitioners  deem  in¬ 
oculation  of  infants  warrantable,  but  not  even  then  otherwise  than  to  avoid  the  casual 
disease.  Of  the  effects  of  inoculation  of  infants  with  the  cow-pox  infection,  we  have  but 
one  or  two  examples:  however,  these  are  in  favor  of  the  practice. 

Toothing.  Though  the  tender,  irritable  state  of  a  new-born  child  may  be  a  more  dan¬ 
gerous  one  with  the  small-pox,  than  even  the  state  of  actual  great  irritation  during 
the  cutting  of  teeth  with  this  disease,  yet  the  evidence  in  point  of  safety  is  against  in¬ 
oculating  the  smallpox  in  the  latter  cases.  This  being  the  fact,  we  shall  feel  inclined, 
under  the  circumstances  of  dentition,  to  inoculate  for  the  cow-pox,  if  exposure  to  the 
small-pox  infection  be  unavoidable. 

Peculiar  morbid  states.  Certain  diseases  have  been  found  to  have  no  influence  in  occa¬ 
sioning  the  inoculated  small-pox  to  take  place  in  a  severe  manner.  On  the  contrary,  it 
appears  that  some  of  these  diseased  states  render  the  small-pox  milder.  But  of  the  in¬ 
fluence  of  such  morbid  conditions  on  the  cow-pox,  wo  possess  no  experience  to  author¬ 
ize  an  opinion.  There  are  some  states  induced  by  particular  diseases,  namely,  by  the 
measles,  whooping-cough,  etc  ,  which  are  considered  to  be  the  occasion  of  severe  disease 
in  the  inoculated  small-pox;  and  from  this  consideration,  under  the  circumstance  of  un¬ 
avoidable  exposure  to  the  small-pox  infection,  il  seems  warrantable  to  prefer  the  inocu¬ 
lation  of  the  cow-pox. 

Peculiar  states  of  health,  Idiosyncrasies.  The  cases  of  certain  families  in  which  the 
small-pox  is  uncommonly  severe,  and  of  other  families  in  which  it  is  very  mild,  are  so 
frequent  as  to  have  fallen  under  the  notice  of  every  physician  of  experience.  Some 
families  have  been  so  unfortunate  that  all  their  children  have  died  in  the  small-pox, 
either  in  the  casual  way  or  by  inoculation.  It  is  not  a  very  great  rarity  to  find  a  fam¬ 
ily  in  which  several  children  have  fallen  victims  to  the  small-pox,  and  in  which  a  sin¬ 
gle  surviving  child  remains  ;  in  such  case,  the  parents,  and  perhaps  the  child,  are  under 
constant  apprehensions  of  the  casual  small-pox,  for  they  are  deferred  from  inoculation  by 
what  has  happened.  Surely,  in  such  circumstances,  one  would  bo  inclined  to  commend 
inoculation  for  tha  cow-pox. 


*  Succus  nutritius  ct  chylosus  matris,  ex  poris  ct  vasculis  u tennis  interventu  membrause  villosa; 
tenuissima!  qua'  chorio  contigua  est,  non  secus  ac  cbylus  a  tunica  intestinorum  villosa  recipitur,  absorbetur. 
ct,  per  umbiliealeni  venam  fertile,  ex  qua  cum  sanguine  ad  hepar  infantis  deducitur. - 

Nutritur  infans  mediante  succo  temperato,  gelatinoso  matris,  qni  per  spongiosam  uteri  su,bstantiaru 
transcolatur  et  a  secuntlina  recipitur,  per  cujus  vasa  ad  infantem  defertur _ 

Ipsa  secundina  quatenus  utero  adliairet  ex  ejus  substantia  porosa  succnm  alibilem,  non  vero  sanguineui 
matris  recipit— Ci  edididerunt  veteres,  sauguinem  matris  nutrive  infantem  et  vasa  uteri  cum  vasis  secundina' 
et  foetus  inviceni  connectised  notabile  est,,  liquorem  siphone  umbilicales  arterias  injeetum  per  venam 
umbilicalem  redire,  modo  placenta  illaesa  fuerit ;  ex  quo  apparet,  nullus  dari  anostomoses  vasorum  uteri 
cum  vasis  secuudinae  et  foetus,  neque  sanguinem  foetus  rui  sus  ad  venas  matris  redire.  Placenta  uterina 
ex  innumeris  capillaribus  minimis  vasculis  est  contecta,  per  quae  dura  transit  sanguis  atteritur,  comminuitur 
inque  minimas  partes  ac  globules  dividitur,  inlima  unione  succi  nutritii  cum  sanguine  facta,  ut  liac  ratione 
per  tenues  canaliculos  embryonis  commodius  transire  et  nutritionem  praestare  possit :  unde  revera 
secundina  in  foetibus  vice  fungitur  pulmonem,  qui  in  foetn  a  munere  fuo  vacant,  quod  identldem  in  intiraa 
sanguiris  partinm  coniminutione  earumquo  unione  cum  cbyloso  succo  consistit :  qua  de  causa  etiani  vena 
umbilicalis  id  babet  peculiare  cum  vena  pulmonali  ut  sanguinem  fluxilem  floridum,  et  arterioso  similem 
vehat  quod  omnibus  aliis  venis  negatum  est.— F.  Hoffmann,  t.  1  lib.  1  sect.  11.  cap.  XIII. 

t  See  the  paper  above  cited  on  the  effects  of  variolous  matter  in  pregnant  women. 


Cow-Pox ;  George  Pearson ,  M.  D. 


81 


During  certain  seasons,  or  epidemical*  states.  At  certain  times,  when  the  small-pox  is  ep- 
demical,  it  is  mostly  violent  and  very  fatal,  and  at  other  times  it  is  mostly  neither  vio¬ 
lent  or  very  fatal. 

Such  different  sorts  of  small-pox  seem  to  depend  upon  prevalent  peculiar  states  of 
health  of  people,  rather  than  on  the  properties  of  the  atmosphere.  When  an  unfavor- 
hle  epidemical  state  is  discovered,  the  judicious  practitioner  will  find  the  question 
worthy  of  his  contemplation,  whether  it  will  not  be  justifiable  to  introduce  the  inocula¬ 
tion  of  the  cow-pox  to  supercede  the  small-pox. 

2.  The  kind  of  symptoms  and  the  duration  of  the  two  diseases  must  be  compared  to¬ 
gether.  If  an  inoculator  could,  a t  his  will,  command  an  inoculation  of  the  small-pox, 
a  slight  local  affection,  a  trifling  eruptive  fever,  and  a  very  small  number  of  eruptions, 
there  would  be  no  temptation  held  out  on  the  foree  of  symptoms  to  inoculate  for  the 
cow-pox,  because,  in  this  disease,  it  appears  that  we  are  liable,  even  by  inoculation,  to 
produce  a,  painful  phlegmonic  inflammation,  extensive  and  very  irritating  inflammation 
of  the  skin  around  the  part  poisoned,  and  ulcera  tion  of  the  phagedenic  kind.  A  sufficient 
number  of  cases  of  the  inoculated  cow-pox  has  not  been  attested  to  enable  us  to  form  an 
accurate  judgment  of  the  degree  of  the  symptoms  in  comparison  with  those  of  the  inoc¬ 
ulated  small-pox.  It  does  not  appear  that  there  is  nearly  so  great  a  difference  between 
the  constitutional  disorder,  or  fever,  of  the  inoculated  cow-pox,  and  of  the  casual  cow- 
pox;  as  between  the  disorder  of  the  constitution  of  the  inoculated  small-pox  and  the  casual 
small-pox  ;  nor,  of  course,  are  the  advautagesof  the  inoculated  cow-pox  so  eminently  great, 
comparatively  with  those  of  the  casual  disease,  as  the  advantages  of  the  inoculated 
small-pox  are  superior  to  those  of  this  disease  in  the  casual  way.  On  comparison 
of  the  symptoms  of  the  inoculated  chicken-pox,  the  inoculated  murrain,  and  the 
inoculated  measles,  with  these  diseases,  in  the  casual  way,  by  effluvia,  the  differ¬ 
ence  is  not  so  great  as  to  raise  considerably  our  expectation  of  advantages  from 
the  practice  of  inoculation.  Although  Camper  and  Layard  are  advocates  for  inoculation 
for  the  murrain,  Mons.  de  Berg  gives  a  contrary  opiuion,  declaring,  tQue  l’iuoculation 
n’offre  aucuns  a  vantages  reels;  fur-tout  dans  les  cas  on  l’epizootic  est  tres-meurtriere, 
circonstance  qui  d’ailleurs  est  la  seuie  dans  laquelle  elle  puisse  efre  de  quelque  utilite. 

3.  The  subsequent  effects  on  the  constitution,  from  the  cow-pox,  must  be  compared  with 
those  from  the  inoculated  small-pox.  A  disposition  to  certain  diseases,  and  even  diseases 
themselves,  are  not  rarely  brought  on  by  the  small-pox ;  but  sometimes  also  dispositions 
to  diseases,  and  diseases  themselves  of  the  most  inveterate  kind,  are  removed  by  the 
small-pox.  In  families  wherever  certain  dispositions  to  diseases  are  hereditary,  and 
which  diseases  are  known  to  have  been  excited  by  the  small-pox,  inoculation  for  the 
cow-pox  on  this  account  may  be  a  considerable  benefit ;  but  that  is  on  the  supposition 
that  no  diseases,  or  morbid  dispositions,  are  induced  by  it.  As  far  as  my  inquiries  have 
extended,  I  have  found  that  no  such  morbid  effects  have  ensued  from  the  cow-pox  ;  but  I 
apprehend  that  many  more  observations  than  have  hitherto  been  made,  are  requisite  to 
ascertain  this  point  satisfactorily. 

Although  pits  from  the  small-pox  are  not  a  disease,  they  are  at  least  a  deformity,  which 
it  is  of  the  greatest  moment  for  any  person  to  prevent;  but  which,  however,  no  one 
can  certainly  guard  against,  even  by  inoculation;  and  as  in  the  cow-pox,  no  such  conse¬ 
quences  take  place,  an  inducement  is  afforded  to  inoculate  for  this  disease. 

II.  As  the  small-pox  infection  is  propagated  in  the  state  of  effluvia,  and  by  adhering 
in  an  unseen,  and  even  invisibly  small  quantity,  to  cloths,  furniture,  etc. ;  but  as  the 
cow-pox  infection  is  only  propagated  in  a  visible  quantity,  and  for  the  most  part  only 
when  applied  to  the  divided  cuticle,  the  means  of  avoiding  the  cow-pox  are  easy  and 
obviously  simple.  On  account  of  the  extremely  contagious  nature  of  the  variolous 
poison,  the  extensive  dissemination  of  it  by  inoculation,  and  the  practice  of  inoculating 
for  the  small-pox  being  only  partial,  it  appears  that  the  mortality  by  the  small-pox  has 
been  in  a  greater  proportion  since  than  before  the  introduction  of  inoculation.  And  no 
sagacity  is  required  to  predict,  that  should  the  practice  of  inoculating  for  the  cow-pox. 
ever  become  very  general  amongst  young  persons,  the  variolous  infection  must  be  ex¬ 
tinguished;  and,  of  consequence,  that  loathsome  and  destructive  disease,  the  small-pox, 
be  known  only  by  name.  And  this  benefit  will  accrue,  without  even  the  alloy  of  the  in¬ 
troduction  of  a  new  disease,  it  being  plain  from  the  nature  of  the  cow-pox  poison  that  it 
will  be  easy  to  avoid  and  prevent  its  dissemination. 

III.  The  cow-pox  poison  appears  to  alter  the  human  constitution,  so  as  to  render  it 
unsusceptible  of  the  agency  of  a  different  morbific  poison,  namely,  of  the  variolous,  in 
producing  the  small-pox.  This  fact  is,  I  believe,  quite  a  novelty  in  physiology  and 


*  A  very  mild  and  innocent  endemial  small-pox  occurred  in  the  practice  of  Dr.  Hicks,  of  which  a  history 
is  expected  by  the  professional  public. 

t  Lettre  a  Mons.  Linguet,  p.  28.  Appendix. 


82 


Cow-Pox ;  George  Pearson ,  M.  1). 


pathology;  it  indicates  a  new  principle  in  the  mode  of  prophylatic  practice.  And  we 
now  see  upon  what  principle  diseases  from  various  other  morbific  poisons  may  possibly 
be  prevented  from  taking  place,  such  as  the  measles,  ulcerous  sore  throat,  whooping- 
cough,  syphilis,  etc.,  viz.  in  consequence  of  destroying  the  excitability  of  the  constitu¬ 
tion  to  such  poisons  by  the  agency  of  different  anti  perhaps  less  hurtful  ones.  Whether 
the  cow-pox  preserves  the  constitution  from  other  morbific  poisons,  besides  the  vario¬ 
lous,  is  an  undecided  question.  This  fact  also  suggests  the  idea  that  the  economy  of  live 
beings  may  be  liable  to  undergo  permanent  changes  in  the  state  of  excitability  of  each, 
in  respect  of  certain  stimuli,  both  morbific  and  innocent  ones,  which  observation  has  not 
hitherto  discovered.  And  on  account  of  the  unobserved  agency  of  such  stimuli,  some 
constitutions  are  utterly  incapable,  either  permanently  or  for  a  limited  time,  of  takingthe 
small-pox,  and  perhaps  other  diseases.  But  if  there  are  in  nature  means  of  rendering 
the  human  constitution  unsusceptible,  it  must  be  allowed  that  it  is  probable  there  are 
also  means  of  rendering  it  particularly  disposed  to  certain  diseases.  And  it  is  possible 
that  the  same  constitution  may,  in  the  course  of  life,  undeigo  repeatedly  a  temporary 
state  of  inexcitability  to  certain  stimuli ;  but  there  is  no  reason  to  suppose  that  a  state 
of  inexcitability,  which  would  otherwise  be  permanent,  may  be  removed  by  certain 
morbific  stimuli. 

In  the  veterinary  branch  of  physic  it  is  a  matter  of  still  greater  importance  to  possess 
the  means  of  rendering  the  constitution  unsusceptible  of  the  agency  of  the  morbific 
poison  which  produces  the  murrain  ;  because, 

1.  This  malady  is  more  destructive  when  it  is  epizootic  than  the  small-pox  is  among 
human  creatures:  2.  Because  inoculation  for  it  is  not  nearly  so  beneficial,  a  great  pro¬ 
portion  dying  under  inoculation. 

It  seems  of  small  consequence  in  practice,  but  it  is  very  important  on  account  of  phys¬ 
iology  to  determine,  whether  the  human  economy  is  rendered  unsusceptible  of  the  cow- 
pox  by  having  undergone  the  small-pox  In  the  instances  related,  of  people  taking  the 
cow-pox  who  had  gone  through  the  small-pox,  the  observation  was  not  directed  with  a 
view  to  determine,  satisfactorily,  wTiether  the  local  affection  was  certainly  attended  or 
preceded  by  a  constitutional  affection. 

IV.  If  it  be  true  that  the  same  constitution  is  liable  to  undergo  repeatedly  the  cow- 
pox,  to  which  distemper  no  one  has  fallen  a  victim,  practitioners  may  avail  themselves 
of  this  means  of  exciting  an  innocent  fever  as  a  remedy  of  various  disorders,  it  being  a 
truth,  admitted  by  men  of  experience,  that  fevers  are  occasionally  efficacious  remedies, 
especially  for  inveterate  chronic  maladies,  such  as  epilepsy,  hysteria,  insanity,  St.  Vitus’ 
dance,  tetanus,  skin  deformities  and  diseases,  etc. 

V.  Concerning  the  aetiology  of  the  disease,  which  is  the  subject  of  our  inquiry  :  The 
cowr-pox  in  the  human  animal  has,  in  every  casual  instance  of  the  disease,  been  so  clearly 
traced  immediately  to  the  cow’s  breasts,  affected  with  the  cow-pox,  that  it  would  be 
mispending  time  to  relate,  particularly  the  history  of  cases,  to  prove  what  is  asserted. 
The  inoculation  with  matter  from  the  cow  produces  the  same  disease  as  the  casual  cow- 
pox.  It  appears  also  that  the  cow-pox  matter  of  the  human  animal  excites  the  same 
disease  as  the  matter  from  the  cow.  It  has  not  been  determined  by  experiment,  nor  by 
any  observation  of  incidental  agency  of  cow-pox  matter;  that  this  matter  geneiated  in 
the  human  animal,  will  excite  the  same  disease  in  the  cow;  but  from  the  facts  just 
spoken  of,  probably  few  persons  will  doubt  that  this  must  be  the  case.  The  cow-pox  of 
the  brute  is  either  excited  by  the  matter  conveyed  from  a  beast  laboring  under  the  dis¬ 
ease,  (in  an  obvious  way  by  the  bauds  of  milkers)  to  uninfected  cows;  in  which  manner 
one  diseased  beast  may  inf.ct  an  unlimited  number  of  beasts,  or  the  disease  is  excited  by 
aboriginal  cow-pox  mutter  ;  that  is,  by  matter  compounded  in  the  animal  economy  of  the 
cow,  without  any  matter  of  the  same  kind  having  been  applied.  The  means  by  the 
agency  of  which  the  animal  economy  is  put  into  such  a  state  as  to  compound  this  pecu¬ 
liar  matter  are  not  yet  found  out.  A  connection  is,  however,  observed  between  the  dis¬ 
ease  and  the  spring  season,  the  autumn,  and  change  from  less  nutritious  to  more  nutritious 
food. 

It  has  been  concluded  by  Dr.  Jenner  that  the  aboriginal  matter  is  from  the  matter  of 
the  grease  of  horses,  which  gains  admission  through  the  milkers  who  handle  such  greased 
horses:  but  this  conclusion  lias  no  better  support  than  the  coinc  deuce  in  some  instances 
of  the  prevalence  of  the  two  diseases  in  the  same  farm,  and  in  which  the  same  servants 
are  employed  among  the  horses  and  cows.  This  assertion  stands  in  need  of  support  from 
other  observations.  The  experimentum  cruris  seems  to  have  been  already  instituted,  but 
without  success,  namely,  the  inoculation  with  the  grease  matter  of  the  cow’s  breast  by 
Dr.  Jenner.  It  is  to  excite  further  research,  that  I  shall  mention  how  successful  my  in¬ 
quiries  have  been  to  find  the  origin  of  the  cow-pox  to  be  in  the  grease. 

1.  I  have  found  that  in  many  farms  the  cow-pox  breaks  out,  althoughno  new-comer 
has  been  introduced  into  the  herd  ;  although  the  milkers  do  not  come  in  contact  with 
horses;  although  there  are  no  greased  horses;  and  even  although  there  are  no  horses 
kept  on  the  farm. 


Cow-Pox ;  George  Pearson,  M.  D. 


83 


2.  It  appears  that  the  cow-pox  does  not  break  out  under  the  most  favorable  circum¬ 
stances  for  its  production,  if  it  be  occasioned  by  the  grease.  Through  the  application  of 
my  inestimable  colleague,  Dr.  Win.  Hebeiden,  I  have  got  much  instruction  relating  to 
this  head  from  Sir  Isaac  Pennington.  “1* * * §  have  had,  “says  Sir  Isaac,  “  Dr.  Jenifer's 
book  some  weeks,  and  the  particulars  stated  in  it  are  really  astonishing.  I  have  made 
inquiries  upon  the  subject  at  Cottenham  and  Willingham  ;  in  which  two  parishes  3005 
milch  cows  are  kept,  also  a  great  many  horses  of  the  rough-legged  cart  kind,  (much  lia¬ 
ble  to  the  scratches  or  grease,)  half  the  parishes  being  under  the  plow,  and  the  men  be¬ 
ing  much  employed  in  milking.  But  I  cannot  find  that  any  pustulous  eruptions  on  the 
teats  of  the  cow,  or  on  the  hands  of  the  milkers,  have  ever  been  heard  of,  and  what  seems 
to  prove  the  negative  in  this  case,  I  understand  inoculation  succeeds  just  as  well  in  these 
parishes  as  anywhere  else.  I  cannot  find  from  those  concerned  in  inoculation  that  shoe- 
ing-smitlis  are  less  liable  to  the  infection  of  the  small-pox  than  other  people.” 

Dr.  Parr  is  one  of  the  few  men  of  learning,  and  acknowledged  ability,  who  has  im¬ 
bibed  an  unfavorable  opinion  of  the  whole  of  the  facts  and  reasoning  of  Dr.  Jenner.  But 
as  my  Exeter  friend  merely  opposes  reasoning  and  gratuitous  suppositions,  to  at  least 
some  well-attested  facts,  1  do  not  think  anything  will  be  gained  by  stating,  particularly, 
his  sentiments  on  the  subject,  yet  I  acquiesce  to  his  judgment,  “that  the  assertion  that 
the  cow-pox  proceeds  from  the  heels  of  horses  is  gratuitous.”'  He  reprobates  the  con¬ 
clusions  on  this  part  of  the  subject  in  somewhat  opprobrious  terms,  in  which,  however, 
the  Doctor  himself  argues  more  on  gratuitous  suppositions  than  admitted  truths. 

“Limpidt  fluid  is  always  more  active  than  pus,  for  a  wound  no  longer  spreads  when 
the  matter  becomes  purulent.  If  a  disease  does  proceed  from  the  matter  of  the  heel  of 
the  horse,  if  is  no  other  than  such  as  occurs  in  the  human  subject,  namely,  topical  ulcers, 
from  a  putrid  femes;  since  it  is  probable,  (p.  49,  Jenner)  on  Dr.  .Tenner’s  own  founda¬ 
tion,  the  eruptions  must  precede  its  influence.  Men  servants  seldom  milk  cows  in  this 
country,  and  when  they  do,  such  insufferable  dirtiness  as  to  milk  with  hands  streaming 
with  the  running  of  a  sore  heel,  wouid  not  be  tolerated  in  any  milking  court  in  this 
country.  Indeed,  I  think  this  publication  (Dr.  Jenifer's)  is  a  libel  on  his  own  neighbor¬ 
hood.” 

At  the  close  of  these  adverse  observations,  it  is  but  fair  to  represent  that  this  opinion 
respecting  the  origin  of  the  cow-pox,  is  not  merely  that  of  Dr.  Jenner,  for  Mr.  Smith 
(letter  above  cited)  says.  “Mr.  Woodman  had  a  notion  of  the  cow-pox  originating  from 
the  sore  heels  of  horses.”  And  several  male  servants  at  the  milk  farms  near  London 
saul,  “there  was  such  a  notion  entertained  in  several  parts  in  the  country,  whatever 
might  be  its  foundation.”  , 

The  cow-pox  poison,  and  the  hydrophobic  poison,  are  the  only  specific  morbific  matter 
to  the  human  animal  economy  which  are  clearlv  proved  to  be  derived  from  brute  ani¬ 
mals ;  for  there  is  only  small  probability  on  the  side  of  the  opinion  that  the  syphilitic 
poison  is  from  the  built,  the  small-pox  from  the  eamel||  and  the  itch  from  the  dog.  The 
economy  then  of  the  human  kind,  and  of  cows,  resemble,  in  the  particular  of  being  ex¬ 
citable  to  a  disease,  the  cow-pox.  by  a  certain  specific  poison.  Whether  other  animals, 
especially  males  of  the  bovine  kind,  can  take  the  cow-pox  has  not  been  determined  by 
experiment  or  accidental  observation.  Morbific  poisons,  which  produce  specific  dis¬ 
eases,  act  in  this  way  only  on  one  species  of  animals,  except  in  a  few  instances,  such  as 
the  hydrophobic  and  cow-pox  poisons.  Camper,  Ingenhousz  and  Woodville  in  vain  at¬ 
tempted  to  produce  the  small-pox  by  inoculation  in  a  number  of  different  brute  animals. § 
J.  Hunter  failed  in  attempting  to  excite  the  syphilis  in  a  d.«g  by  inoculating  him  with 
the  poison  of  the  gonorrlme  aud  of  a  syphilitic  ulcer.  Camper  attests  that  in  the  most 
malignant  epizootic  murrain,  which  spread  most  rapid.y  among  oxen,  yet  other  an¬ 
imals,  such  as  sheep,  horses,  asses,  dogs,  etc.,  were  not  infected  by  associating  with  the 
distempered  oxen,  nor  even  by  feeding  with  them  in  the  same  compartments  of  a  stable. 

In  the  eruptive  contagious  disease  among  sheep  m  France  forty  years  ago,  other  spe¬ 
cies  of  animals  which  associated  with  them  were  not  infected. 

The  newly-observed  disease,  which  prevailed  among  domestic  cats  in  1796,  throughout 
great  part  of  Europe,  and  even  America,  did  not  appear  to  affect  other  animals. 


*  Sir  Isaac  Pennington’s  Letter,  Cambridge,  Sept.  14,  1798. 

t  Dr.  Parr’s,  M.  D.,  Letter,  Exeter,  July  22,  1798. 

J  Bulls  so  diseased  are  said  to  be  stung. — Sir  Isaac  Pennington’s  Letter. 

||  See  Bruce's  Travels  and  Dr.  Woodville’s  History  of  Inoculation. 

§  Berrier,  of  Chartres,  asserts  that  monkeys,  dogs,  sheep,  rabbits,  oxen  and  other  brute  animals,  are  sus¬ 
ceptible  of  the  small-pox  ;  but  his  evidence  lias  not  the  weight  of  a  feather  against  the  contrary  authorities. 

Swediaur  asserts  that  monkeys  are  never  affected  with  the  svphilis.  although  in  England  they  are  subject 
to  the  scrofula,  and  that  other  animals  are  equally  unsusceptible  of  the  syphilis,  although  Pauw  affirms  that 
in  Peru  dogs  are  affected  with  this  disease, 


84 


Cow-Pox ;  George  Pearson ,  M.  1). 


These  observations  may  serve  to  remove  the  fears  of  those  who  apprehend,  that  in  con¬ 
sequence  of  domesticating  brute  creatures,  we  are  liable  to  render  their  diseases  en- 
demial. 

VI.  As  it  appears  that  the  cow-pox  poison, "after  its  admission  into  the  human  consti¬ 
tution,  takes  effect,  or  sensibly  exerts  its  agency  upon  the  whole  economy,  in  seven  or 
eight  days,  it  seems  probable  that  it  will  anticipate,  in  many  instances,  the  agency  of  the 
small-pox  poison,  if  the  two  poisons  be  introduced  at  the  same  time,  or  nearly  so ;  in 
which  case  the  patients  should  be  in  future  incapable  of  the  small-pox. 

If  the  morbific  poison  of  the  varicella,  or  chicken-pox,  were  to  be  inserted  at  the  same 
time  with  the  cow-pox  poison,  it  is  probable  also  that  the  cow-pox  would  suspend  the 
chicken-pox,  and  perhaps  render  the  constitution  unsusceptible  of  its  action  in  future. 
But  if  it  be  a  truth  that  the  rubeolous  poison  can  be  inserted  by  inoculation,  and  that  it 
affects  the  constitution  in  six  days,  when  this  poison  and  that  of  the  cow-pox  are  intro¬ 
duced  at  the  same  time,  it  is  most  likely  the  measles  will  suspend  the  cow-pox. 

So  long  as  the  constitution  is  under  the  agency  of  the  cow-pox  poison,  it  is  not  proba¬ 
ble  that  it  will  be  infected  by  those  morbific  pbisons  whose  existence  is  only  known  by 
their  effects,  (for  they  operate  in  too  minute  a  quantity  to  fall  under  the  notice  of  our 
senses)  namely,  the  poison  which  occasions  the  influenza,  whooping-cough,  ulcerous  an  - 
gina,  that  which  occasions  the  typhus  fever,  the  miasmata  and  the  contagion  of  inter- 
mittentvfevers,  etc. 

To  give  an  instance  of  the  application  of  facts  to  practice:  if  a  woman  be  far  ad¬ 
vanced  in  pregnancy,  and  exposure  to  small-pox  infection  has  been,  or  is  unavoidable,  in 
that  case  it  will  be  of  vast  importance  to  avert  the  present  impending  danger  from  the 
female.  Under  such  a  circumstance  the  temptation  to  inoculate  for  the  cow-pox  Avill 
be  felt  by  the  practitioner.  And  provided  the  inoculation  be  instituted  in  not  more,  than 
six  or  seven  days  after  exposure  to  the  variolous  infection,  it  should,  according  to  prin¬ 
ciple,  pretty  certainly  preserve  the  patient  from  small-pox;  or  if  it  be  done  within  ten  or 
twelve  days,  it  should  frequently  answer  the  purpose.  For  the  variolous  poison  lies 
within  the  human  body,  most  frequently,  fifteen  days,  and  often  four  or  five  days  later, 
before  its  general  agency  is  perceived;  whereas,  the  cow-pox  poison  acts  upon  the  whole 
constitution  in  seven  or  eight  days  after  its  admission. 

VII.  The  cow-pox  poison  is,  according  to  the  present  facts,  totally  different  in  its  na¬ 
ture  and  effects  from  every  oilier  morbific  poison,  both  of  cattle  and  human  creatures. 
It  is  not  necessary  to  enter  minutely  into  the  distinguishing  characters  of  it  as  it  appears 
in  cows,  as  these  will  be  collected  from  the  history  of  the  disease.  I  think  it  right  just 
to  mention  that  care  should  be  taken  not  to  confound  the  cow-pox  withtlie  common  wart 
eruptions  and  inflammations  ending  in  scabs,  which  affect  the  paps  only,  or  at  most  the 
paps  and  the  udders.  It  must  also  b,e  recollected  that  the  cow-pox  is  quite  different  from 
the  diseases  of  cattle  which  are  attended  with  eruptions  of  the  skin  in  general,  such  as 
take  place  in  the  murrain,  or pestis  bovilla,  already  spoken  of,  on  which  eruptive  diseases 
more  has  been  written  by  the  Italian,  French  and  Dutch  physicians  than  by  the  English*, 

On  account  of  the  notion  which,  by  some,  is  entertained,  that  the  cow-pox  infection  is 
of  the  same  nature  as  the  variolous,  it  may  be  useful  to  point  out  the  great  differences 
between  them. 

1.  The  cow-pox  poison,  introduced  by  inoculation,  affects  the  whole  constitution  at 
the  same  time  in  the  same  degree  and  manner  as  when  admitted  in  the  casual  way  ;  and 
if  the  local  affection  be  more  severe  in  the  casual  than  in  the  inoculated  way,  it  seems  to 
be  owing  to  the  structure  of  the  part,  namely,  the  thick  cuticle  in  the  palms  of  the 
hands. 

2.  The  cow-pox  poison  only  affects  the  constitution  through  the  intervention  of  the 
part  poisoued. 

3.  This  morbific  poison  produces  no  eruption  or  inflammation,  but  of  and  near  the  part 
to  which  the  poison  is  applied. 

*  Gli  assisteuzi  a’bovi  ammalati  e  molt’  altri  uomini  degui  di  fede  m’attestarono  d’aver  osservati,  in  alcuni 
tumori  crudi  in  diverse  parti  del  corpo  con  lingue  aride,  n  ;re  e  tagliate,  in  altri  aver  veduti  tumori  matu- 
i-ate. — P.  A.  Micliellot.i,  p.  12,  1711. 

La  terza  osservazione  fa  circa  alcnni  buovi,  che  dimorarano  in  ima  stalla  come  alle  pecore  :  due  di  essi 
cacciarono  d’  alia  cute  certi  tubercolletti.— Padre  Boromeo,  p.  48. 

Aunis  1713,  1714,  in  nostro  Ferrariensi  Ducatu,  lues  contagiosa  bourn,  &c.  Correpti  enim  boves  cibum 
respuebaut;  aures  subito  collaps®  proeidebant:  pili  erigebantus ;  tremor  pene  universalis  aderat:  oculi 
laorymabant :  per  nares  multa  lymph®  copia  exibat;  alvus  solvebatur-  et  in  aliquibus  pustulai  Sub  cute 
prodibant,  ita  ut  crederent  aliqui  Variolis  boves  ipsos  assici ;  tandemque  brevi  septem  dierum  spatio  ruo- 
riebantur. — J.  Lanzoni,  t.  20,  b.  202. 

Maculis  denique  et  pustulis  infecta  cutis,  adeo  ut  quibusdam,  in  mentem  venerit  cogitare  boves  non  leu, 
ut  nunc  res  est,  sed  ipsis  pustulis  quas  Variolas  vocanb  interire. — J.  M.  Laneisi  de  bovilla  peste 

Sclireiben  an  (lie  Generalst.iaten  betreffend  die  Einimpfung  (ler  Viebseuche  gescbrieben  den  1G  Fe.br. 
1770. — Camper  von  Einimpfung  der  Kindviebseuelie,  ibren  Vortheilen  und  Bedingungen. — Campers  Ber¬ 
liner  Gesellscbaft. 


Cow-Pox ;  George  Pearson ,  il/.  D. 


85 


4.  The  cow-pox  poison  from  the  human  subject  will,  in  all  probability,  infect  the  cow 
with  the  cow-pox,  which  the  variolous  poison  will  not. 

5.  It  is  asserted  that  a  person  may  have  the  cow-pox  who  has  had  the  small-pox. 

6.  The  local  pustulous  eruptions  in  the  cow-pox  are  rather  in  the  nature  of  vesicles, 
or  phylyctar »,  than  purulent  eruptions,  and  the  ulceration  is  apt  to  be  of  the  phage¬ 
denic  kind. 

7.  The  tow. pox  infection  is  not  propagated  in  the  state  of  effluvia  or  gas. 

8.  Cow-pox  matter  applied  to  the  eyes,  lips  and  various  other  soft  parts,  or  to  any 
parts  which  are  punctured,  or  wounded,  in  persons  who  already  have  had  the  cow-pox,  or 
are  then  ill  of  the  disease,  will  excite  the  peculiar  local  affection  from  this  poison,  and 
perhaps  fever. 

VIII.  There  are  some  who  are  not  certain  whether  or  not  they  have  gone  through  the 
small-pox,  yet  they  have  such  a  dread  of  the  disease  as  not  to  submit  even  to  inoculation 
for  it.  To  such  persons  the  inoculation  for  the  cow-pox  as  a  substitute  for  the  small-pox 
must  prove  a  happy  discovery. 

Some  who  have  never  gone  through  the  small-pox  have  been  repeatedly  inoculated  for 
the  small-pox,  and  also  been  exposed  much  to  the  infection  of  it  in  the  casual  way,  yet 
could  not  be  infected.  Persons  so  circumstanced  to  be  more  secure,  may  be  inoculated 
for  the  cow-pox. 

Such  is  the  representation  which  I  shall  lay  before  the  public  of  the  benefits  likely  to 
accrue  to  human  society  from  inoculation  for  the  cow-pox.  I  shall  be  no  better  con¬ 
tented  with  those  who  will  consider  the  facts  to  be  already  completely  demonstrated, 
than  with  the  opposite  extreme  opinion,  that  the  whole  of  the  prospects  displayed  are 
merely  Eutopian.  The  fortunes  of  the  new  proposed  practice  cannot,  with  certainty, 
be  told  at  present  by  the  most  discerning  minds.  More  instances  are  required  to  estab¬ 
lish  practical  and  pathological  truths  Without  assuming  pretensions  which,  I  think, 
unwarrantable,  the  number  of  instances  farther  requisite  can  not  be  stated  ;  but  one 
may  safely  assert  that  well  directed  observation  in  a,  thousand  cases  of  inoculated  cow- 
pox  would  not  fail  to  produce  such  a  valuable  body  of  evidence  as  will  enable  us  to  ap¬ 
ply  our  knowledge  with  much  usefulness  in  practice,  and  establish,  or  at  least  bring  us 
nearer  the  establishment,  of  some  truths. 

They  who  take  a  part  in  the  present  inquiry  must  not  expect  to  escape  detraction  • 
But  such  a  prospect  will  not  divert  him  from  his  path  who  labors  in  the  culture  of 
physic  for  the  satisfaction  of  his  own  mind,  well  knowing  that  it  argues  egregious  ignor¬ 
ance  of  what  is  passing  in  the  world,  to  do  so  from  any  other  motive. 


COMMUNICATIONS  DECEIVED  AFTER 


TPIE  PRECEDING  SHEETS  WERE 


PRINTED,  AND  ADDITIONAL  OBSERVATIONS. 

Mr.  Rolph,  Surgeon  in  Peckham,  practiced  physic  nine  years  at  Thornbury  in  Glouces¬ 
tershire.  During  two  of  these  years  he  was  the  colleague  of  the  late  Mr.  Grove,  who 
had  been  a  medical  practitioner  at  Thornbury  for  near  forty  years.  The  greater  part  of 
the  facts  above  stated,  relating  to  the  cow-pox,  are  familiarly  known  to  Mr.  Rolph  from 
his  own  observation,  and  from  the  experience  of  Mr.  Grove. 

Mr.  Rolph  tells  me,  that  in  Gloucestershire  the  cow-pox  is  frequently  epizootic  in  the 
dairy  farms  in  the  spring  season.  It  especially  breaks  out  in  cows  newly  introduced  into 
the  herds.  When  a  number  of  cows  in  a  farm  are  at  the  same  time  affected,  the  infection 
seems  generally  to  have  originated  in  the  constitution  of  soma  one  cow,  and  before  the 
milker  is  aware  of  the  existence  of  the  disease,  the  infectious  matter  is  probably  con¬ 
veyed  by  the  hands  to  the  teats  and  udders  of  other  cows  ;  hence  they  are  infected.  For 
if  the  disease  in  the  cow  first  affected  be  perceived  in  a  certain  state,  and  obvious  pre¬ 
cautions  be  taken,  the  infection  does  not  spread,  but  is  confined  to  a  single  beast. 
Whether  the  morbific  poison  is  generated  in  the  cow  first  diseased  in  a  given  farm,  de 
novo,  from  time  to  time,  and  disseminated  among  the  rest  of  the  herd;  or,  like  the  small¬ 
pox  poison,  is  onl>  communicated  from  animals  of  the  same  species  to  one  another,  is  not 
ascertained,  No  cow  has  been  known  to  die  or  be  in  danger  from  this  disorder. 

A  great  number  of  instances  of  the  cow-pox  in  milkers  had  fallen  under  Mr.  Rolph  s 
observation,  and  many  hundreds  more  under  that  of  his  late  partner,  Mr.  Grove;  but 
not  a  single  mortal,  or  even  dangerous,  case  had  occurred.  The  patients  were  ordinarily 
ill  of  a  slight  fever  for  two  or  three  days,  and  the  local  affection  was  so  slight  that,  the 
assistance  of  medical  practitioners  was  rarely  required.  He  had  no  doubt  that  the  inoc¬ 
ulated  cow-pox  was  attended  with  as  little  pain  and  uneasiuess  as  the  ordinary  cases  ot 
inoculated  small-pox. 


80 


Cow-Pox ;  George  Pearson ,  M.  J>. 


Mi-.  Eolph  says,  there  is  not  a  medical  practitioner  of  even  little  experience  in  Glou¬ 
cestershire,  or  scarce  a  dairy  farmer,  who  does  not  know  from  his  own  experience,  or  that 
ot  others,  that  persons  who  have  suffered  the  cow-pox  are  exempted  from  the  agency  of 
the  variolous  poison. 

The  late  Mr.  Grove  was  a  very  extensive  small-pox  inoculat or,  frequently  having  200 
or  300  patients  at  one  time,  and  the  fact  of  exemption  now  asserted  had  been  long  before 
his  death  abundantly  established  by  his  experience  of  many  scores  of  subjects  who  had 
previously  labored  under  the  cow-pox,  being  found  unsusceptible  to  the  small-pox,  either 
by  inoculation  or  by  effluvia. 

While  Mr.  Eolph  practiced  at  Thorhbury,  he  thinks  not  fewer  than  tliree-scorce  in¬ 
stances  of  failure  in  attempting  to  produce  the  small-pox  by  inoculation  occurred  in  his 
own  practice,  all  of  which  were  persons  who  had  been  previously  affected  with  the  cow- 
pox.  In  alinost  all  of  these  cases  the  uninfected  persons  associated  with  those  who  took 
the  small-pox',  and  many  were  repeatedly  inoculated.  Although  Mr.  Eolph  has  not,  in 
his  recollection,  any  instances  of  people  taking  the  small-pox  who  ga  ve  admissible  evi¬ 
dence  of  their  having  labored  under  the  cow-pox,  he  thinks  such  cases  may,  and  have 
indeed  occurred  to  others,  where  the  cow-pox  had  been  only  local,  it  being  requisite  that 
the  whole  constitution  should  be  affected  in  order  to  destroy  the  excitability  to  the  vari¬ 
olous  poison. 

Mr.  Eolph  declared  that  his  confidence  in  the  efficacy  and  safety  of  inoculation  for  the 
cow-pox  was  such  that  he  regretted  he  could  not,  at  present,  procure  cow-pox  matter  to 
inoculate  two  of  his  own  children  who  had  not  yet  had  the  small-pox.  This  measure  is, 
however,  determined  upon. 

As  a  particular  instance,  Mr.  Eolph  related  the  following:  A  soldier’s  wife,  while  in 
the  small-pox,  was  accidentally  in  the  company  of  several  farmers  at  an  ale-house  in 
Thorn  bury.  Two  of  the  company  who  had  gone  through  the  cow-pox.  but  not  the  small¬ 
pox,  were  not  infected  by  the  variolous  infection  ;  but  three  others,  who  had  not  labored 
under  the  cow-pox,  took  the  small-pox. 

Mr.  Eolph’s  mind  was  not  satisfied  that  a  person  could  be  constitutionally  affected  by 
the  cow-pox  poison  more  than  once,  but  he  had  no  doubt  that  the  local  affection 
might  be  produced  repeatedly.  Neither  did  he  certainly  know  that  a  person  was  unsus¬ 
ceptible  ot  the  small-pox  who  had  been  constitutionally  affected  by  the  cow-pox. 

Mr.  Eolph,  in  a  letter  to  Dr.  Beddoes,  dated  June  10th,  1795,  communicated  the  follow¬ 
ing  observations.  Speaking  of  a  man  who  could  not  be  infected,  although  he  was  re¬ 
peatedly  inoculated  for  the  small-pox,  and  although  he  lived  in  the  same  room  with  an¬ 
other  man  who  died  of  the  small-pox,  Mr.  Eolph  says,  “  it  is  worthy*  of  remark  that  this 
man  had  some  years  before  a  complaint  incident  to  cows,  and  commonly  called  the  cow- 
pox,  a  malady  more  unpleasant  than  dangerous.  It  is  generally  received  by  contact  in 
milking.  In  the  human  species  the  complaint  is  sometimes  local,  at  other  times  absorp¬ 
tion  takes  place,  and  the  glands  in  the  course  of  the  absorbents  become  indurated  and 
painful.  When  this  is  the  case,  I  have  learned  from  my  own  observation,  and  the  testimony 
of  some  old  practitioners ,  that  susceptibility  to  the  small-pox  is  destroyed.  Some  advantage 
may  probably,  in  time,  be  derived  from  this  fact.” 


LETTEE  FEOM  DE.  JENNEE  TO  DE.  PEAESON. 

Cheltenham,  27tb  September,  1798. 

My  Dear  Sir — The  perusal  of  your  proof  sheets  has  afforded  me  great  pleasure,  both  from  the  handsome 
manner  in  which  you  mention  my  name,  and  from  the  mass  of  evidence  which  has  poured  in  upon  \ou  from 
different  countries  in  support  of  the  fact  which  I  so  ardently  wish  to  see  established  on  a  steady  and  dura¬ 
ble-  basis 

Your  first  query  respecting  the  foetus  in  utero  I  can  not  resolve. 

With  respect  to  your  second,  you  may  be  assured  that  a  person  may  he  repeatedly  affected,  both  locally 
and  generally,  by  the  cow-pox,  t  wo  instances  of  which  I  have  adduced,  and  have  many  more  in  my  recollec¬ 
tion.  But,  nevertheless,  on  this  important  point,  1  have  some  reason  to  suspect  that  my  discriminations 
have  not  been,  till  lately,  sufficiently  nice.  I  must  observe  to  you.  that  what  the  constitution  feels  from  the 
absorption  of  the  virusf,  is  of  a  mild  and  transient  nature,  but  the  sores  (which  sores,  when  casual,  are 
often  numerous,  and  attended  with  such  soreness  and  inflammation)  are  sufficient  of  themselves  to  occasion 
much  disorder  in  the  system.  Certain  it  is,  that  the  skin  is  always  subject  to  the  ulcerative  effects  of  th>- 
virus,  but  whether  the  constitution  can  repeatedly  feel  the.  primary  effects  of  it,  I  liavl  experiments  in  view 
to  determine.  Let  me  here  call  your  attention  to  a  similarity  between  the  small-pox  and  the  cow-pox.  The 
symptoms  of  absorption  first  disturb  the  system,  and,  secondly,  the  system  >  feels  the  consequences  of  the 
local  sores.  Exactly  so  with  the  cow-pox;  and  as  the  cow-pox  inflammation  is  always  of  the  erysipelatous 
kind,  when  it  spreads  over  the  skin  to  any  great  extent,  it  produces  symptoms  not  unlike  the  confluent 
small-pox 

It  is  painful  to  me  to  tell  you,  that  I  have  not  an  atom  of  the  matter  that  I  can  depend  upon  for  continu¬ 
ing  the  experiments.  Mr.  — - .  when  lie  inoculated  the  hoy,  did  not  ta>  e  matter  early  enough  from 

■*  See  the  queries  of  Dr.  Beddoes  concerning  inoculation,  subjoined  to  his  translation  of  Gimbernet’s 
method  of  operating  for  the  femoral  hernia. — London,  Johnson,  1795. 

1 1  use  this  expression  as  the  common  language  of  the  day,  without  consenting  to  the  truth  of  it. 


Cow-Pox ;  George  Pearson ,  M.  V. 


87 


the  pustule  to  secure  its  efficacy, — for  after  it  lias  lost  its  limpid  quality,  and  becomes  pus,  I  fear  its  specific 
effects  cease.  Much  precaution  is  therefore  necessary  in  tlie  progress  of  the  inquiry  ;  and  this  is  my  grand 
fear,  that  the  discovery  may  fall  into  discredit  from  a  want  of  that  attention,  iri  conducting  the  experi¬ 
ments  which  the  subject  requires.  For  example,  a  person  may  conceive  he  has  the  cow-pox  matter  o  •  his  lancet, 
when,  in  fact,  there  may  be  only  a  little  putrid  pus — with  this  he  scratches  the  skin  and  excites  disease  ; — 
the  patient  is  afterwards  subjected  to  the  insertion  of  the  variidous  poison,  and  unquestionably  will  have 
the  disease.  Thus  a  delusive  inference  will  be  drawn,  at  once  hurtful  to  the  cause,  and  particularly  injuri¬ 
ous  to  me.  However,  truth  must  appear  at  last,  and  from  your  researches ,  its  appearance  will  certainly  he 
expedited.  I  remain,  yours  very  truly,  E.  JENNER. 

Abstract  of  a  Letter  from  Mr.  Fewster,  Surgeon  in  Thornbury,  dated.  October  lltli, 
1798,  to  Mr.* Ralpli,  Surgeon  in  Peckbain. 

In  the  spring  of  the  year  1768  I  came  to  live  at  Thornbury,  where  I  have  resided  ever  sinco.  In  that 
very  year,  from  the  following  occurrence,  I  became  well  acquainted  with  the  disease  called  cow-pox.  The 
late  Mr.  G-rove  and  myself  formed  a  connection  with  Mr.  Sutton,  the  celebrated  inoculator  ;  and  to  inocu¬ 
late  for  the  small  pox,  we  took  a  house  at  Buckover.  We  found  in  this  practice  that  a  great  number  of  pa¬ 
tients  could  not  he  infected  with  the  small-pox  poison,  notwithstanding  repeated  exposure  under  most 
favorable  circumstances  for  taking  the  disease.  At  length  the  cause  of  the  failure  was  discovered  from 
the  case  of  a  farmer  who  was  inoculated  several  times  ineffectually,  yet  he  assured  us  he  had  never  suf¬ 
fered  the  small  pox,  hut,  says  he.  “J  have  had  the  cow-pox  lately  to  a  violent  degree,  if  that's  any  odds." 
We  took  the  hint,  and,  on  inquiry,  found  that  all  those  who  were  uninfectable  had  undergone  the  cow-pox.  I 
communicated  this  fact  to  a  medical  society,  of  which  I  was  then  a  member,  and  ever  afterwards  paid  par¬ 
ticular  attention  to  determine  the  fact.  I  can  now,  with  truth,  affirm  that  I  have  not  been  able  to  produce 
the  small-pox ,  in  a  single  instance ,  among  persons  who  have  had  the  true  cow. pox,  except  a  doubtful  ease 
which  you  are  acquainted  with.  I  have,  since  that,  inoculated  near  two  thousand  for  the  small-pox. 
amongst  whom  there  were  a  great  number  who  had  gone  through  the  cow-pox;  the  exact  number  of  these  1 
can  not  tell,  but  I  know  that  they  all  resisted  the  infection  of  variolous  matter. 

With  regard  to  your  questions  ; 

1.  As  to  danger  from  the  cow-pox.  In  the  course  of  thirty  years  I  have  known  numberless  instances  of 
the  disease,  but  never  knew  one  mortal,  or  even  dangerous,  case. 

2.  Is  a  person  susceptible  of  the  cow-pox  more  than  once?  I  can  not  answer  this  question, 

3.  Is  the  cow-pox,  in  the  natural  way,  a  more  or  less  severe  disease  than  the  inoculated  cow-pox?  I 
think  it  is  a  much  more  severe  disease  in  general  than  the  inoculated  small  pox.  I  do  not  see  any  great  ad¬ 
vantage  from  inoculation  for  the  cow  pox.  Inoculation  for  the  small-pox  seems  to  be  so  well  understood, 
that  there  is  very  little  need  of  a  substitute  It  is  curious,  however,  and  may  lead  to  other  improvements*. 

4.  Have  you  ever  known  any  pregnant  woman  labor  under  the  cow-pox  ?  Tes,  many',  but  it  newer  pro¬ 
duced  abortion.  The  state  of  the  foetus  1  can  not  speak  of, 

5.  Are  cows'  affected  at  certain  times  more  than  at  others?  They  are  especially  effected  from  Febru¬ 
ary  to  May,  when  there  is  the  greatest  number  of  greased  horses. 

I  cau  not  procure  any  cow-pox  matter  this  season. 

From  Mr.  Bird  to  Dr.  Pearson,  October  16,  1798. 

Mr.  G.  G.  Bird,  of  Hereford,  who  is  now  attending  medical  lectures  in  London,  tells  Dr.  P.  that  he  has 
very  often  seen  the  cow-pox  m  cows  and  human  creatures  near  Gloucester;  that  it  attacks  the  same  person 
repeatedly,  and  once  the  third  attack  was  observed  to  be  more  severe  than  the  preceding  ones,  but  ordina¬ 
rily  the  reverse  is  the  fact.  It  appears  with  red  spots  on  the  hands,  which  enlarge,  become  roundish  and 
suppurate,  tumors  take  place  in  the  armpit,  the  pulse  grows  quick,  the  head  aches,  pains  are  felt  in  the  back 
and  limbs,  with  sometimes  vomiting  and  delirium .  It  is  most  common  in  a  wet  spring.  Ho  one  dies  of  the 
disease. 

Dr.  Currie,  of  Chester,  informs  Mr.  Thomas  that  the  disease  called  cow-pox  is  unknown  to  the  medi¬ 
cal  practitioners  and  farmers  in  Cheshire. 

Dr  Richard  Pearson,  of  Birmingham,  in  his  obliging  letter  of  the  26th  September  last,  says,  From 
this  united  evidence,  i  that  of  medical  persons  and  farmers)  I  think  that  it  may  be  inferred  that  the  disease, 
which  Ur.  Jenner  calls  variolas  vicciuae,  is  not  epizootic  in  the  counties  of  Warwick,  AForeestev  and 
Stafford.” 

Dr.  Wood ville  acquaints  me,  “  that  not  being  able  to  procure  cow-pox  matter  he  is  making  trials  with 
grease  matter  from  which  no  doubt,  some  useful  information  will  be  obtained.” 

Extracts  of  a  letter  from  Mr.  Thomas  Wales,  surgeon  at  Downliam,  Norfolk,  dated 
October  18,  1798,  to  Dr.  Pearson.  I  shall  endeavor  to  give  you  satifactory  answers  to 
your  queries. 

Previous  to  my  conversation  with  Dr.  Redfearn,  I  had  no  knowledge  of  the  disease  called  cow-pox,  nor  was 
it  known  to  any  medical  practioner  in  this  district  But  ou  inquiring  at  the  dairy  farms,  I  have  got  much 
iuformaiion  concerning  the  disease.  1  this  day  saw  two  persons  wao  have  had  the  cow-pox.  One  of  them, 
a  man  above  sixty  years  of  ago,  who  lias  been  a  milker  all  his  life,  knows  the  disease  very  well  by  the  name 
of  pap  pox,  having  himself  experienced  the  disorder  a  great  many  years  ago.  He  remembers  that  on  that 
occasion  lie  was  sick  at  the  stomach  and  otherwise  ill  for  two  or  three  days.  The  eruption  on  his  hands 
was  considerable,  and  the  lingers  were  swollen  ;  probably  owing  to  improper  applications  the  places  healed 
slowly,  and  left  scars,  which  are  evident  at  this  day;  and  when  the  hands  are  very  cold,  these  scars  are  of  a 
livid  cast.  He  had  not  gone  through  the  small-pox  before  hehad  the  cow  pox  nor  has  he  had  the  small-pox 
since  this  disease,  although  he  has  been  repeatedly  inoculated. 

The  other  cas  >  above  mentioned,  is  that  of  a  young  woman,  who  had  the  cow-pox  some  time  ago  hut  never 
suff'ered.the  small-box  although  she  has  been  several  times  inoculated. 

There  are,  I  find,  many  other  instances,  of  persons  who  have  gone  through  the  cow-pox,  and  who  have 
not  been  able  to  take  the  small  pox,  either'  naturally,  or  by  inoculation . 

As  the  public  in  this  part  are  not  at  all  aware  of  the  advantages  of  inoculation  for  the  cow-pox,  there  are 
no  instances  of  this  mode  of  producing  it. 


*  I  have  stated  the  writer’s  opinion  of  inoculation  for  the  cow-pox,  in  obedience  to  a  law  imposed  on  my¬ 
self,  of  not  suppressing  any  part  of  the  evidence  communicated,  however  differently  I  might  reason  ou  the 
acts. — Note  by  the  author  of  this  inquiry. 


88 


Cow-Pox ;  George  Pearson ,  M.  1). 


I  do  not  find  that  any  person  has  had  the  cow-pox  more  than  once,  that  is  a  fever  with  the  local  affection 
more  than  once;  but  the  local  affection  without  fever,  has  occurred  in  the  same  person  repeatedly  ;  I  have 
met  with  two  cases,  in  which  t  lie,  matter  of  the  cow-pox,  by  being  applied  to  the  eyes,  destroyed  the  power 
of  vision,  from  the  opacity  of  the  cornea  so  produced. 

No  person  has  been  known  to  die,  or  even  to  be  in  danger,  with  the  cow-pox,  although  the  axillary  glands 
have  been  much  affected,  and  the  sores  on  the  hands  have  healed  with  difficulty.  I  have  not  met  with  a 
case  of  a  woman  who  has  gone  through  the  disease  during  pregnancy. 

No  instance  has  fallen  under  my  observation,  of  a  person  who  has  gene  through  the  cow-pox  after  hav¬ 
ing  had  the  small-pox. 

With  regard  to  cows  they  are  subject  to  the  cow-pox  more  than  once.  It  comes  on  in  the  spring,  when 
they  first  begin  to  taste  luxuriant  food,  but  not  uniformly  every  year.  One  farmer  informed  me  that  he 
thought  it  broke  out  especially  when  the  cows  were  fed  with  turnip’s  iu  autumn  ;  but  I  do  not  depend  much 
on  this  observation.” 

* 


REMARKS  ON  THE  TERM  ^ARIOL.E  VACCIN.E. 

For  the  sake  of  precision  in  language,  and  of  consequence,  justness  in  thinking ;  and  considering  that 
there  is  no  other  way  of  disabusing  ourselves  from  many  of  the  errors  in  physic,  but  by  the  use  of  just 
terms ;  it  is  not  unworthy  of  our  attention  to  guard  against  the  admission  of  newly  appropriated  names  which 
will  mislead  by  their  former  accepted  import. 

Variola  is  an  assumed  Latin  word,  and  its  meaning  will  be  popularly  understood  in  the  English  tongue,  by 
saying  that  it  is  a  name  of  a  disease,  better  known  by  another  name,  the  small-pox.  Granting  that  the  word 
variola  is  a  derivative  from  varius  and  varus  used  by  Pliny  and  Celsus  to  denote  a  disease,  with  spots  on 
the  skin  the  etymological  import  of  variola  is  any  cutaneous  spotted  distemper ;  but  one  of  the  most  formid¬ 
able  and  distinct  of  the  cutaneous  order  is  what  is  called  the  small  pox,  and  therefore,  as  I  apprehend  the 
name  variola  has  been  used  technically  to  signify  this  kind  of  spotted  malady,  and  no  other. 

Now  as  the  cow-pox  is  a  specially  different  distemper  from  the  small-pox,  in  essential  particulars,  namely, 
iu  the  nature  of  its  morbific  poison,  and  in  its  symptoms  ;  although  the  cow-pox  may  render  the  constitution 
not  susceptible  of  the  small-pox ;  it  is  a  palpable  catachresis  to  designate  what  is  called  the  cow-pox,  by  the 
denomination  variolce  vaccince  ;  for  that  is  to  say,  in  English,  cow  small-pox,  and  yet  the  cow  is  unsuscepti¬ 
ble  of  infection  by  the  variolous  poison. 

To  the  name  cow-pox  or  better,  perhaps  cow-pocken*  in  our  language,  I  think  no  reasonable  objection  can 
be  urged.  According  to  the  more  distinct  and  lucid  arrangement  of  cutaneous  distempers,  by  Ur.  Wil¬ 
kin. t  the  cow-pox  belongs  to  the  order  entitled  pustulas  ;  the  word  puck  is  known  to  signify  pustule  and  the 
prefix  cow  denotes  the  only  animal  in  which  the  morbific  poison  has  its  origin.  Further;  if  here¬ 
after  by  the  practice  of  universal  inoculation,  the  human  animal  should  be  much  more  abundant,  and  better 
known  source  of  this  morbific  matter  than  the  brute  animal,  it  is  fit  that  the  latter,  to  which  obligations 
will  be  owing  for  an  inestimable  benefit,  should  live  in  the  grateful  memory  of  mankind,  as  ought  also 
the  name  of  J enner  who  will  be  so  great  a  public  benefactor. 

QUERIES. 

It  may  save  some  persons  the  trouble  of  thinking,  and.  time,  if  a  set  of  questions  be 
stated;  which  will  serve  to  guide  observation  iu  the  acquisition  of  facts  belonging  to 
the  subject  of  inquiry.  For  this  purpose  the  following  queries  are  proposed  : 

WITH  RESPECT  TO  BRUTES.  „ 

1.  If  a  distemper  of  cows  has  been  noticed,  called  the  cow-pox,  or  by  any  other  name, 
in  which  the  beasts,  especially  the  paps,  are  affected  with  pustulous,  and  generally  pur¬ 
ple,  or  livid  eruptions  and  sores,  by  which  the  hands  of  milkers  are  infected  ;  what  are 
the  symptoms  ? 

2.  Can  any  connection  be  traced  betwixt  this  disease  and  the  grease  of  horses’  heels  ? 
between  the  disease  and  particular  kinds  of  food  and  water?  between  it  and  any  par¬ 
ticular  state  of  the  atlnnosphere?  between  it  and  any  particular  season  ? 

3.  Is  the  same  liable  to  the  disease  more  than  once  ? 

4.  Has  any  cow  ever  appeared  to  die  of  this  disease? 

5.  Is  the  cow  susceptible  of  the  cow-pox  by  the  inoculation  of  the  breasts,  with  grease 
matter  of  horses  ? 

6.  Are  males  of  the  ox  kind,  or  other  different  kinds  of  brutes,  susceptible  of  the 
disease  by  inoculation  with  cow-pox  matter  of  cows  ? 

7.  Have  cows  in  a  state  of  pregnancy  been  observed  to  be  affected  with  this  distemper  ? 

8.  Is  the  cow  susceptible  of  the  disease  by  inoculation  of  other  parts  beside  the 
breasts  ? 

9.  Is  the  cow-pox  matter  of  human  creatures  capable  of  producing  cow-pox  in  cows 

WITH  RESPECT  TO  HUMAN  CREATURES. 

1.  What  parts  are  affected,  and  what  are  the  symptoms  of  the  distemper  when  con¬ 
tracted  in  the  casual  way  ? 


*Instead  of  the  modern  orthography  small-pox,  etc  ,  in  which  es  and  eks  are  denoted  by  x,  it  will  he,  per¬ 
haps,  thought  preferable  to  follow  the  original  orthography  pock  with  its  plural  pocken ,  as  the  Germans 
still  do  ;  from  whose  language  we  have  received  the  words. 

tDescription  and  treatment  of  cutaneous  disorders.  Order  1.  Pustulous  eruptions  on  the  skin,  by 
Robert  Willan,  F.  A.  S.  4to.  with  plates,  Johnson.  1798. 


Cow  Pox :  Georye  Pearson ,  M.  J). 


89 


2.  TTas  any  person  been  supposed  to  be  in  danger,  or  to  have  died  of  the  disease  ? 

3.  Is  the  -whole  constitution  disordered  previously,  or  only  at  the  same  time  the  pustules 
breakout?  Does  the  disorder  of  the  constitution  disappear  on  the  appearance  of  the 
pustules?  Does  the  same,  or  a  different  disorder  of  the  constitution  again  appear; 
and  under  what  circumstances  in  the  course  of  the  disease? 

4.  If  in  the  course  of  the  disease,  when  there  is  no  disorder  of  the  whole  constitution, 
the  infectious  matter  of  the  cow  or  of  the  human  patient  already  laboring  under  the 
cow-pox  be  applied  to  fresh  parts,  does  a  disorder  of  the  whole  constitution  arise,  as  well 
as  a  local  affection  ;  and  of  the  same  kind  as  those  which  have  already  taken  place  ? 

5.  Is  the  same  person  susceptible  of  the  cow-pox  local  affection,  and  fever,  or  disorder 
of  the  whole  constitution  more  than  once  or  only  of  the  local  affection  more  than 
once  ?  In  the  instances  in  which  the  disorder  of  the  whole  constitution  was  said  to 
have  occurred  more  than  once,  is  it  not  probable  that  in  one  case  only  the  specific  fever 
of  the  infection  occurred,  and  in  the  others  a  different  disorder  of  the  whole  constitu¬ 
tion,  such  as  was  merely  from  the  irritation  of  the  local  affection  ? 

6.  Is  the  local  affection  of  the  same  nature  on  a  second,  or  on  farther  attacks  m  the 
same  as  on  the  first  ? 

7.  In  the  instances  of  cow-pox  in  persons  who  had  gone  through  the  small-pox,  were 
the  local  affection  and  disorder  of  the  constitution  of  the  same  nature  as  in  persons  who 
had  not  labored  under  the  small-pox? 

8.  Has  it  been  observed  that  a  person  has  ever  taken  the  small-pox  after  having  gone 
through  the  cow-pox  ?  In  the  instances  in  which  the  small-pox  was  said  to  have  taken 
place,  was  it  certain  that  the  preceding  cow-pox  was  attendant  with  its  specific  fever, 
or  was  there  only  a  local  affection,  or  at  most,  was  there  only  disorder  symtomatic  of  the 
local  affection  ? 

9.  Does  the  cow-pox  render  the  human  constitution  unsusceptible  of  any  other  disease 
besides  the  small-pox ;  or  on  the  contrary,  increase  its  susceptibility  to  any  particular 
disease  ? 

10.  What  are  the  effects  of  cow-pox  on  pregnant  women? 

11.  In  the  inoculated  cow-pox  is  the  fever  less  considerable  than  in  the  casual  way? 

12.  In  the  inoculated  cow-pox  is  the  local  fever  slighter  and  of  shorter  duration  than 

in  the  casual  cow-pox  ?  * 

13.  How  long  after  the  insertion  of  the  matter  is  it  before  the  constitution  is  affected  ? 

14.  If  a  person  were  to  be  inoculated  at  the  same  time  with  cow-pox  and  variolous 
matter,  which  disorder  would  appear  first,  or  what  other  effects  would  be  produced? 

15.  If  the  cow-pox  morbific  matter  be  applied  to  a  secreting  membrane,  e.  g.  to  the 
urethra,  will  it  produce  a  gonorrhoea  or  pustulous  sores  ? 

10.  Does  the  disease  appear  to  injure  the  constitution,  by  producing  or  exciting  other 
diseases  ? 

17.  Does  the  disease  appear  to  eradicate  any  other  disease  already  present  ? 

18.  Does  the  mildness  or  severity  of  the  inoculated  cow-pox  depend  upon  the  quantity 
of  the  matter  inserted,  or  on  the  wounds  inflicted  for  iuoculation  ? 

19.  Does  the  cow-pox  matter  produce  the  disease  as  certainly  in  its  dried  as  its  fluid 
state;  and  when  old  as  when  recent;  and  with  equal  mildness? 

20.  Are  there  any  particular  states  of  the  constitution  in  which  cow-pox  is  particu¬ 
larly  mild  ;  or  on  the  contrary,  severe  ;  as  after  the  measles,  whoopiug-cough,  etc.  ? 

21.  Are  there  particular  idiosyncrasies  in  families  or  individuals,  which  influence  the 
cow-pox,  as  is  the  case  in  the  small-pox  ? 

22.  Is  the  inoculation  of  the  cow-pox  equally  successful  in  infancy,  manhood,  and  de¬ 
crepit  age  ? 

Answers  to  the  preceding  questions  will  be  principally  obtained  by  inoculation  for  the 
cow-pox,  of  which  there  are  many  opportunities  in  provincial  situations  ;  which  prac¬ 
tice  it  is  one  of  the  chief  objects  of  this  publication  to  encourage. 

23.  Do  certain  epidemic  states  appear  to  prevail,  which  influence  this  disease  ? 

IV  S. — Extracts  of  a  letter  from  Dr.  Fowler  to  Dr.  Pearson,  dated  Sarum,  October,  24, 
1798: 

My  Dear  Sir — The  disease  called  cow-pox  is  known  in  this  neighborhood  only  to  a  few  farmers,' but  they 
understand  that  it  is  a  preservative  from  the  small  pox.  This  morning.  Anne  Francis,  a  servant  girl,  ageu 
26  years,  was  brought  to  me  ;  she  informs  me,  that  some  years  ago  bluish  pustules  arose  on  mu'  Lianas,  trom 
milking  cows  diseased  by  the  cow-pox.  These  pustules  soon  became  scabs,  which  falling  on,  cuscoveie 
ulcerating  and  very  painful,  which  were  treated  by  a  cow  doctor,  and  were  long  in  ln-aling.  borne  mu n 
from  mm  of  the  diseased  cows  having  spurted  on  the  cheek  of  her  sister,  and  on  the  breast  of  her  Hiistiess. 
produced  on  these  parts  of  both  persons,  pustules  and  sores,  similar  to  her  own  on  be'r  hands,  jsoneot 


90 


Cow  lJox  :  George  Pearson ,  M.  1). 


these  tliree  had  suffered  the  small  pox,  nor  have  they  gone  through  it  since  that  time,  although  they  have 
been  mucn  exposed  to  the  infection ;  and  the  sister  above  mentioned  has  been  inoculated  three  times  for  the 
small-pox.  The  cew  doctor  who  attended  these  three  women  said,  he  would  forfeit  his  life  if  any  of  them 
should  afterwards  have  the  small-pox. 

With  sincerest  good  wishes'for  the  success.of  this  and  all  your  undertakings, 

I  am,  etc.-,  ete.  11.  EOWLEK, 

Note— Mr.  Hughes’  letter,  dated  Stroud-Water,  Gloucestershire,  October  27,  1798,  to  Mr.  Bliss,  Surgeon- 
Hampstead,  has  been  just  sent  to  the  author,  in  answer  to  his  queries.  Unfortunately  this  valuable  left  r 
cannot  now  be  published.  It  especially  confirms,  by  a  number  of  instances,  the  facts  of  the  safety  of  the 
cow-pox,  and  of  its  producing  unsusceptibility  of  the  small  pox. 

FINIS. 


Reports  of  a  Series  of  Inoculations 

— FOR  THE — 

YAPTOLRE  VACCrOB,  or  00 W  POX ; 

— WITH— 

REMARKS  AND  OBSERVATIONS  OK  THIS  DISEASE,  CONSID¬ 


ERED  AS  A  SUBSTITUTE 


-FOR- 


TELE!  SMALL-POX, 

By  WILLIAM  WOODYILLE,  M.  D.,  Physician  to  flic  Small-Pox  and 

Inoculation  Hospitals. 


LONDON : 

Printed  and  Sold  by  James  Phillips  &  Son,  George  Yard,  Lombard  street.  1799. 


* 


(  U-  (  £  'j  }-' 


. 


:  /■ 


* 


- 


{ 


TO  THE  EIGHT  HONORABLE  SIR  JOSEPH  BANKS,  Bart. 

Knight  of  the  Bath,  President  of  the  Royal  Society,  etc. : 

Sir — The  great  attention  with  which  you  honored  some  of  the  first  cases 
described  in  the  following  sheets  has  induced  me  to  hope,  that  on  account 
of  the  whole,  though  not  affording  the  satisfactory  evidence  upon  the  sub¬ 
ject  that  I  expected,  may  still  not  be  entirely  unacceptable  to  you. 

I  have  the  honor  to  be  with  the  utmost  regard,  your  obedient  servant, 

W.  WOODYILLE. 


Ely-Place,  May  16,  1799. 


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REPORTS,  ETC. 


Last  summer  Dr.  .Tenner  presented  to  the  public*  several  curious  and  interesting;  facts, 
respecting  a  disease  known  to  dairy  farmers  by  the  name  of  cow-pox.  The  most  impor¬ 
tant  of  these  is,  that  persons  who  have  been  effected  with  this  distemper  are  thereby 
rendered  as  secure  from  the  effects  of  the  variolous  infection  as  if  they  had  actually  un¬ 
dergone  the  small-pox. 

However  extraordinary  this  circumstance  may  appear,  it  is  supported  by  numerous 
experiments  made  under  Dr.  Jenner’s  inspection,  and  also  by  concurrent  testimonies 
since  collected  by  Dr.  Pearson,!  who  with  much  laudable  zeal  and  industry  instituted  a 
further  inquiry  into  the  subject. 

Dr.  Jenuer,  who  from  his  situation  in  Gloucestershire,  had  many  opportunities  of 
seeing  the  cow-pox,  supposes  it  to  originate  from  the  grease  in  horses,  and  to  take  place 
in  the  following  manner  : 

“In  this  dairy  country  a  great  number  of  cows  are  kept,  and  the  office  of  milking  is 
performed  indiscriminately  by  men  and  maid  servants.  One  of  the  former  having  been 
appointed  to  apply  dressings  to  the  heels  of  a  horse  affected  with  the  grease,  and  not 
paying  due  attention  to  cleanliness,  incautiously  bears  his  part  in  milking  the  cows, 
with  some  particles  of  the  infectious  matter  adhering  to  his  lingers.  When  this  is  the 
case,  it  commonly  happens  that  a  disease  is  communicated  to  the  cows,  and  from  the 
cows  to  the  dai  ry-maids,  which  spreads  through  the  farm,  until  most  of  the  cattle  and 
domestics  feel  its  unpleasant  consequences.  This  disease  has  obtained  the  name  of  cow- 
pox.  It  appears  on  the  nipples  of  the  cows,  in  the  form  of  irregular  pustules.  At 
their  first  appearance  they  are  commonly  of  a  palish  blue,  or  rather  of  a  color  somewhat 
approaching  to  livid,  and  surmounted  by  an  erysipelatous  inflammation.  These  pus¬ 
tules,  unless  a  timely  remedy  be  applied,  frequently  degenerate  into  phagedenic  u leeks. 
The  animals  become  indisposed,  and  the  secrei ion  of  milk  is  much  lessened.  Inflamed 
spots  now  begin  to  appear  on  different  parts  of  the  hands  of  the  domestics  employed  in 
milking,  and  sometimes  on  the  wrists,  which  quickly  run  on  to  suppuration,  first  assum¬ 
ing  the  appearance  of  small  vesications,  produced  by  a  burn.  Most  commonly  they  ap¬ 
pear  about  the  joints  of  the  fingers,  and  at  their  extremities  ;  but  whatever  parts  are  af¬ 
fected.  if  the  situation  will  admit,  these  superficial  suppurations  put  on  a  circular  form, 
with  their  edges  more  elevated  than  their  centre,  and  of  a  color  distantly  approaching 
to  blue.  Absorption  takes  place,  and  tumorsappear  in  each  axilla.  The  system  becomes 
affected — the  pulse  is  quickened;  and  shiverings,  with  general  lassitude  and  pains 
about  tlie  loins  and  limbs,  with  vomiting,  come  on.  The  head  is  painful,  and  the  patient 
is  now  and  then  eveu  affected  with  delirium.  These  symptoms,  varying  in  their  degree 
of  violence  generally,  continue  from  one  day  to  three  or  four,  leaving  ulcerated  sores 
about  the  hands,  which,  from  the  sensibility  of  the  parts,  are  very  troublesome,  and 
commonly  heal  slowly,  frequently  becoming  phagedenic  like  those  from  whence  they 
sprung. 

’“Thus  the  disease  makes  its  progress  from  the  horse  to  the  nipple  of  the  cow,  and  from 
the  cow  to  the  human  subject. ” 

Since  no  fatal  effects  have  ever  been  known  to  arise  from  the  cow-pox,  even  when  im¬ 
pressed  in  the  most  unfavorable  manner;  and  since  this  disease  appears  from  numerous 
instances  to  leave  the  constitution  in  a  state  of  perfect  security  from  the  infection  of  the 
small-pox,  Dr.  .Jenner  infers,  that  the  employment  of  the  matter  of  the  cow-pox 
would  be  preferable  to  that  of  the  small-pox,  for  the  purpose  of  inoculation.  In  con¬ 
firmation  of  his  opinion,  it  may  be  observed,  that  he  relates  the  cases  of  seven  or  eight 
persons  whom  he  successfully  inoculated  with  this  new  antidote  to  the  variolous  poison. 

Possessed  of  the  above  information  I  confess  1  became  very  anxious  to  try  the  effect 
of  inoculating  the  matter  of  this  singular  disease,  and  as  trials  could  be  made  not  only 
with  safety,  but  also  with  the  prospect  of  advantage,  I  conceived  it  to  be  a  duty  that 
f  owed  to  the  public  in  my  official  situation  at  the  Inoculating  Hospital  to  embrace  the 
first  opportunity  of  carrying  the  plan  into  execution. 


*.See  an  inquiry' into  the  causes  and  effects  of  the  variolas  vaccinae,  a  disease  discovered  in  some  of  the 
western  counties  of  England,  particularly  Gloucestershire  and  known  by  the  name  of  the  cow-pox, 
tSee  an  inquiry  concerning  the  history  of  cow-pox. 


96 


Cow  Fox  :  William  Woodville ,  M.  I). 


Unfortunately,  however,  at  the  time  Dr.  Jenner’s  publication  appeared,  no  cow-pox 
matter  could  he  procured,  for  the  disease  had  then  become  extinct ;  nor  was  it  expected 
to  return  till  the  spring,  the  period  at  which  it  usually  affected  the  cows.  But  conceiv¬ 
ing  that  the  distemper  might  be  produced  by  inoculating  the  nipples  of  cows  with  the 
matter  of  grease  of  horses,  in  conformity  with  the  opinion  above  stated  I  proceeded  to 
try  whether  the  cow-pox  could  be  actually  excited  in  this  manner. 

Numerous  experiments  were  accordingly  made  upon  different  cows,  with  the  matter  of 
grease,  taken  m  the  various  stages  of  that  disease,  but  without  producing  the  desired 
effect ;  my  friend,  Mr.  Coleman,  the  ingenious  professor  at  the  Veterinary  College,  like¬ 
wise  made  similar  trials,  which  proved  equally  unsuccessful.*  Neither  were  inocula- 
lations  with  this  matter,  nor  with  several  other  morbid  secretions  in  the  horse,  produc¬ 
tive  of  any  effects  upon  the  human  subject. 

I  am  aware,  that  the  experiments  I  allude  to,  may,  by  some,  not  be  deemed  wholly 
conclusive  from  a  supposition  that  the  peculiar  predisposition  of  the  cows,  necessary  to 
render  the  inoculations  efficient,  might  not  exist  at  the  time  the  matter  was  applied  to 
their  nipples. 

But  I  have  also  other  reasons  for  believing  that  the  cow-pox  does  not  originate  from 
any  disease  of  the  horse.  In  the  first  place,  the  affirmative  opinion  is  confessedly  gratu¬ 
itous.  A  horse,  at  a  certain  season  of  the  year,  becomes  affected  with  the  grease,  and  the 
cows  at  the  same  time  are  affected  with  cow-pox  :  and  from  this  coincidence  the  two  dis¬ 
eases  have  been  considered  as  cause  and  effect.  Yet  is  it  not  equally  probable  that  the 
same  temporary  causes  which  produce  a  certain  disorder  in  one  animal  may  so  operate 
upon  another  animal  of  a  different  genus  as  to  excite  another  disorder  ?  Therefore, 
though  the  cow-pox  may  break  out  among  the  cows  at  the  time  that  the  grease  affects 
the  horses  kept  on  the  same  farm,  yet,  the  consecutive  appearance  of  these  diseases 
affords  no  proof  of  their  connection  ;  while,  on  the  other  hand,  J  can  adduce  instances 
iu  which  the  former  disease  has  broken  out  under  such  circumstances  as  render  it  highly 
improbable,  if  not  impossible,  that  it,  should  have  been  caused  by  the  latter.! 

But,  though  Dr.  Jenner  seems  to  have  been  misled  with  respect  to  the  origin  of  the 
cow-pox,  still  his  facts  and  observations  concerning  its  effects  upon  mankind  are  not  the 
less  valid  and  important;  nor  did  I  feel  the  less  desirous  to  try  how  far  they  would  be 
invalidated  or  confirmed  by  a  more  enlarged  experience  than  he  had  the  opportunity  of 
acquiring. 

Towards  the  latter  end  of  January  last  I  was  informed  that  the  cow-pox  had  appeared 
Among  several  of  the  milch  cotvs  kept  in  Gray’s  Inn  Lane,  and  upon  examination  of 
these,  three  or  four  were  discovered  to  be  affected  with  pustulous  sores  upon  their  teats 
and  udders.  These  pustules  corresponded  in  their  appearance  with  the  representation 
and  description  of  the  genuine  cow-pox,  as  given  by  Dr.  Jenner.  I  should  not,  however, 
call  the  surrounding  inflammation  erysipelatous;  it  was  evidently  an  indurated  tume¬ 
faction  of  the  skin.  The  number  of  cows  kept  at  this  place  was  at  this  time  about  two 
hundred,  and  about  four-fifths  of  them  were  eventually  infected. +  * 

The  hands  of  three  or  four  persons  became  sore  in  consequence  of  milking  the  cows 
thus  affected;  and  one  of  them,  Sarah  Rice,  exhibited  so  perfect  a  specimen. of  the  dis¬ 
ease  that  I  could  entertain  no  doubt  of  its  being  the  true,  and  not  the  spurious,  cow- 
pox. 

Several  gentlemen  who  I  knew  would  be  highly  gratified  by  seeing  the  disease  as  it 
appeared  upon  the  girl’s  arm,  were  invited  to  meet  me  at  the  cow-house  on  the  following 
day,  when  Lord  Summerville,  Sir  Joseph  Banks,  Sir  Win.  Watson,  Drs.  Simmons,  Pear¬ 
son,  Willan,  and  others,  attended.  This  was  on  the  24th  of  January  last,  and  Sarah  Rice 
had  then  been  affected  five  days. •  The  appearance  of  the  disease  upon  the  girl’s  hand 
and  arm  very  much  resembled  the  representation  of  it  given  in  the  first  plate  of*  Dr. 
Jenner’s  pamphlet  At  first  a  small  tumor  or  circular  vesication  appeared  between  her 
fingers  ;  next  day  she  discovered  three  more  like  the  first,  namely,  one  upon  her  fiijger, 
another  at  the  wrist,  and  also  one  upon  the  middle  of  her  forearm.  The  two  first  never 
became  larger,  and  exactly  resembled  the  vesicle  upon  the  finger  in  I  he  plate  alluded  to  ; 
that  at  the  wrist  was  now  about  one-third  of  an  inch  in  diameter,  and  the  other  upon 
her  arm  was  still  larger;  they  were  both  of  a  circular  form,  not  depressed  at  the  centre, 
and  had  a  simple  inflammatory  border;  the  pellicle  of  both  these  tumors,  but  more 
especially  of  the  larger,  had  at  this  time  acquired  a  blue  color,  which  was  deepest  about 
the  centre.  This  blueness  had  come  on  during  the  last  twenty-four  hours ;  for  I  had 
seen  the  tumors  the  preceding  day,  when  this  colored  tinge  could  scarcely  be  perceived, 

*Mr.  Coleman  caused  one  of  his  cows  to  bo  inoculated  i.i  its  teats  with  cow-pox  matter  and  that  taken 
from  a  variolous  pustule,  without  effect :  but  the  former  matter,  after  being  regenerated  by  the  human  sub¬ 
ject,  produced  tbe  disease  in  the  cow. 

f  Those  who  wish  for  further  information  on  this  subject,  may  consult  Mr.  Simmons’  Experiments  and 
Dr.  Pearson’s  Inquiry,  pp.  83-84. 

f  Those  cows  which  were  not  in  milk  escaped  the  disease. 


Cow  Fox  :  William  Woodville,  M.  i>. 


97 


and  that  too  only  in  the  largest ;  at  that  time  also  it  contained  a  colorless  fluid,  but  now 
its  contents  appeared  brownish.  The  girl  now  perceived  an  uneasiness  at  the  axilla;  and 
I  afterwards  learned  that  this  symptom  was  followed  by  a  slight  headache.  None  of  the 
tumors  were  painful,  and  they  all  gradually  went  off  without  producing  ulceration. 

Sarah  Rice  had  undergone  the  small-pox  when  a  child;  and  the  only  reason  why  she 
was  more  affected  by  milking  the  diseased  cows  than  the  other  milkers  were,  was  that 
her  hands  and  arms  were  more  red,  swollen,  and  disposed  to  chap  than  theirs;  though  it 
does  not  appear  that  there  were  any  abrasions  of  the  cuticle  of  those  parts  of  the  skin 
which  were  infected  by  the  cow-pox. 

Before  relating  the  cases  of  inoculation  with  the  matter  of  cow-pox,  I  have  judged  it 
proper  in  the  first  place  briefly  to  state  what  are  the  local  effects  produced  by  inoculat¬ 
ing  variolous  matter,  so  that  the  progress  of  the  infection  in  both  cases  may  be  compared, 
and  the  subject  of  inoculation  at  large,  be  better  understood. 

In  cases  wherein  inoculation  of  the  small-pox  proves  effectual,  a  small  particle  of  va¬ 
riolous  matter  being  applied  bj  a  superficial  puncture  of  the  skin,  usually  produces  in 
the  course  of  three  or  four  days,  or  sooner,  a  little  elevation  of  the  punctured  part,  dis¬ 
coverable  by  the  touch,  and  a  red  speck  distinguishable  by  the  eye.  From  this  time  the 
redness  advances  in  a  circular  form,  more  or  less  rapidly,  according  to  the  constitutional 
circumstances  of  the  patient;  and  the  first  effect  of  this  superficial  inflammation  is  the 
formation  of  a  vesicle  upon  its  centre,  which  usually  appears  between  the  fourth  and 
seventh  day  after  the  inoculation.  The  extent  of  the  vesicle  is  generally  found  to  bear 
some  proportion  to  the  intensity  of  the  inflammation  ;  and  contains  a  limpid  fluid,  by 
the  absorption  of  which  the  small-pox  is  produced.  The  vesicle  6oon  bursts,  and  the 
central  part  of  the  puncture  becomes  depressed,  and  often  of  a  dark  hue  ;  which  appear¬ 
ances,  together  with  the  marginal  inflammation,  continue  to  increase  till  the  eruptive 
symptoms  subside,  when  the  edges  of  the  depressed  part  begin  to  swell  with  a  purulent 
fluid,  and  the  inflammation  gradually  recedes. 

Thus  it  appears  that  the  variolous  matter,  first  inserted  by  the  puncture,  like  that  of 
other  morbid  poisons,  is  not  capable  of  being  immediately  absorbed,  but  lodges  in  the 
skin,  and  there  excites  an  inflammatory  process,  by  which  a  new  matter,  producing  the 
disease  is  generated*.  It  would  seem  also  that  this  process  is  carried  to  a  greater  or  less 
extent  in  different  persons  before  the  matter  enters  the  absorbents,  owing  probably  to 
the  greater  or  less  aptitude  in  these  vessels  to  receive  it ;  hence  we  find  the  local  inflam¬ 
mation,  in  some  cases,  considerably  advanced  before  the  system  becomes  affected,  while 
in  others  the  eruptive  symptoms  supervene  when  it  appears  to  have  made  but  very  little 
progress;  and,  therefore,  though  the  eighth  day  after  the  inoculation,  proves  the  usual 
period  at  which  the  patient  feels  indisposed,  yet  this  frequently  happens  much  sooner  or 
later,  and  the  progress  of  the  cow-pox  infection  will  be  found  to  take  the  same  latitude. 

Monday,  January  21,  1799,  I  took  the  matter  of  cow-pox  in  a  purulent  state  upon  the 
teats  of  a  cow,  with  which  I  immediately  inoculated  seven  persons  by  a  single  puncture 
in  the  arm  of  each,  or  rather  by  scratching  the  skin  with  the  point  of  a  lancet  till  the 
instrument  became  tinged  with  blood. 


FIRST  CASE. 

Mary  Payne,  a  child,  two  years  and  a-half  old,  of  a  strong,  robust  constitution.  Third  Day. — The  in¬ 
oculated  part  was  evidently  ulcerated  and  slightly  inflamed-  Sixth  Day. — The  local  tumor  ex¬ 
tended  to  about  one-third  of  an  inch  in  diameter,  and  was  nearly  of  a  circular  form,  with  its 
edges  more  elevated  than  the  centre,  and,  with  the  surrounding  inflammation,  not  greater  than 
is  usual  in  cases  of  inoculated  small-pox.  The  vesicle,  upon  the  middle  of  the  tumor,  was  now 
very  large,  and  distended  with  a  limpid  fluid,  some  of  which  I  took  upon  a  lancet  and  with  it  inoculated 
another  person,  John  Talley.  She  appeared  dull  and  drowsy,  and  her  pulse  was  quicker  than  usual.  She 
had  no  appetite  for  food,  and  had  been  very  thirsty  since  yesterday.  Eighth  Day. — The  redness  surround 
ing  the  tumor  seems  returning;  and  the  thirst  and  other  febrile  symptoms  are  much  abated;  but  she 
still  appears  lifeless  and  somewhat  indisposed.  Eleventh  Day. — She  is  perfectly  free  from  complaint;  the 
inoculated  part  is  scabbing,  but  surrounded  with  a  hard  tumefaction  of  a  bright  red  color.  She  was  this  day 
inoculated  with  variolous  matter.  Fifteenth  Day, — She  has  no  ailment.  The  variolous  inoculation  pro¬ 
duced  considerable  inflammation,  which  gradually  disappeared  after  the  fifth  day, 

SECOND  CASE. 

Elizabeth  Payne,  aged  four  months,  in  appearance  weak  amd  somewhat  emaciated.  The  progress  of  the 
infection  on  this  child's  arm  was  very  much  like  that  of  her  sister’s,  just  mentioned:  but  the  vesication 
seemed  rather  more  extensive,  and  the  surrounding  inflammation  less.  The  sixth  day  after  inoculation  her 
mother  informed  mo  that  the  child  had  been  very  unwell  the  preceding  night  with  what  were  called  inward 
convulsions,  and  had  vomited  two  or  three  times.  On  examination,  the  heat  of  her  skin,  and  the  fre¬ 
quency  other  pulse,  indicated  the  presence  of  some  degree  of  fever.  Eighth  Day. — I  learned  that  the 


*In  the  second  volume  of  the  History  of  Inoculation,  now  nearly  ready  for  the  press,  I  have  endeavored 
to  show  that  the  general  greater  mildness  of  the  inoculated  than  the  casual  small  pox  depends  upon  this 
circumstance. 


98 


Cow  Pox  :  William  Woodville,  M.  1). 


febrile  state  bad  continued,  more  or  less,  till  this  morning;  nor  was  it  then  wholly  gone  off,  The  inoculated 
part,  I  judged  from  its  appearance,  had  not,  entirely  ceased  from  disordering  the  constitution.  Eleventh 
Day. — The  redness  of  the  tumor  is  subsiding,  and  its  general  appearance  resembles  the  effects  of  inocula- 
lation  with  variolous  matter  when  the  eruption  is  completed,  and  the  maturation  proceeding  favorably. 
The  patient’s  mother  now  thinks  her  as  well  as  usual.  She  was  this  day  inoculated  with  variolous  matter. 
Thirteenth  Day. — She  manifests  no  signs  of  indisposition .  The  redness  about  the  tumor  is  gone  off,  and 
the  n  atter  is  forming  a  scab.  The  second  inoculation  produces  no  effect.  Fifteenth  Day. — She  is  now  very 
well;  but  her  mother  says  she  was  seized  with  inward  convulsions  yesterday,  and  was  extremely  ill  after¬ 
ward  for  two  hours  ;  this,  however,  cannot  be  justly  ascribed  to  inoculation,  as  the  part  in  which  the  cow- 
pox  matter  was  inserted  is  now  covered  with  a  dry  scab,  not  attended  with  inflammation  ;  and  the  variolous 
matter  produced  no  redness  whatever.  She  was  this  day  brought  to  a  man  laboring  tinder  the  casual  small¬ 
pox,  and  kissed  by  him,  in  order  more  fully  to  try  if  she  was  secure  from  the  infection  of  the  small-pox. 
Her  sister,  Mary  Payne,  was  also  subjected  to  the  same  test,  but  neither  of  them  have  since  taken  the  dis¬ 
ease. 


THIRD  CASE. 

Thomas  Buckland,  a  strong  child,  four  months  old.  The  progress  ot  the  infection  on  the  boy’s  arms 
was  even  more  regular  and  produced  appearances  more  analogous  to  those  of  the  inoculated  small-pox  than 
in  the  case  of  Mary  Payne.  The  vesicle  on  the  inoculated  part  formed  on  the  third  day,  and  the  surround¬ 
ing  inflammation  never  became  phlegmonous,  nor  was  it  attended  with  any  hardness  of  the  integuments. 
Seventh  day. — In  the  evening  he  was  discovered  to  be  feverish  and  restless,  when  two  pustules  exactly  re¬ 
sembling  those  of  the  small  pox  appeared  near  to  the  inoculated  part.  The  following  day  he  still  continued 
indisposed,  and  the  cutaneous  inflammation  had  that  peculiar  irritable  or  angry  aspect  which  is  observed  on 
the  accession  of  the  eruptive  symptoms  in  cases  of  inflammation  with  variolous  matter.  Tenth  day. — The 
suppuration  was  more  extended,  and  the  efflorescence  immediately  encompassing  it,  had  nearly  disap¬ 
peared,  leaving  its  border  more  strongly  marked  than  theinner  ;  a  circumstance  of  the  most  favorable  im¬ 
port  in  inoculation  The  two  pustules  upon  his  arm  were  more  advanced,  and  several  others  were  visibleupon 
different  parts  of  his  body,  his  ankles  and  feet  were  beset  with  a  rash  like  scarlatina.  He  is  still  feverish, 
and  his  mother  reports  that  last  night  he  vomited  Eleventh  day..— The  soreness  of  his  arm,  and  the  fever 
had  ceased.  Nine  distinct  pustules  were  now  discovered  upon  his  body  and  limbs,  somewhat  smallei  than 
variolous  pustules  ;  from  one  of  these  I  obtained  an  ichorous  matter,  and  with  it  inoculated  Sarah  Price. 
Thirteenth  day. — The  febrile  symptoms  returned  yesteiday,  nor  is  be  wholly  free  from  them  to-day.  Nine 
additional  pustules  have  appeared  ;  no  inflammation  remains  at  the  inoculated  part,  and  the  matter  it  con¬ 
tains  begins  to  dry.  Fifteenth  day.  He  is  free  from  disorder ;  six  pustules  have  appeared  making  in  the 
whole  twenty-four,  some  of  them"  maturate  at  the  apex,  but  they  mostly  die  away  without  proceeding  to 
suppuration.  He  was  this  day  exposed.to  the  effluvia  of  casual  small-pox,  in  the  same  manner  as  the  two 
Paynes. 

FOURTH  CASE. 

Richard  Payne,  a  healthy  boy,  ten  years  old.  The  inoculated  part  was  not  sensibly  elevated  nor  in¬ 
flamed,  till  the  fourth  day.  Seventh  day. — The  tumor  had  spread  considerably  ;  and  the  vesication  upon 
it  was  very  evident.  He  felt  a  sensation  ot  itching  in  the  part;  and  the  next  day  complained  of  a  pain  in 
the  axilla,  which  continued  two  days.  Tenth  day. — The,  centre  of  the  tumor  became  depressed,  its  edges 
elevated,  and  surrounded  by  a  deep-colored  inflammatory  border.  The  central  part  of  the  tumor  was  now 
assuming  externally  a  brown  color  and  in  a  few  days  afterwards  it  formed  a  dark  scab.  Though  considerable 
tumefaction,  with  hardness  and  redness,  remained  at  the  inoculated  part  several  days  yet  no  ulcvration 
ensued.  Fifteenth  day. — Five  pustules  remained  resembling  those  in  Buckland.  This  boy  was  twice  in¬ 
oculated  with  variolous  matter  during  the  progress  of  the  cow-pox  infection,  and  exposed  to  xtatieuts  under 
the  small  pox  the  whole  time,  without  being  infected  by  it ;  and  the  only  complaint  arising  from  the  cow- 
pox  was  the  pain  in  his  arm-pit. 

FIFTH  CASE. 

Matthew  Redding,  sixteen  years  old.  Third  day. — The  insertion  of  the  matter  did  not  appear  to  have 
produced  any  inflammation  or  hardness  in  the  part ;  he  was,  therefore,  inoculated  with  variolous  matter,  at 
the  distance  of  two  inches  from  the  part  in  which  the  cow-pox  matter  was  inserted  Next  day  a  little 
redness  could  be  discovered  at  the  first  puncture,  and  from  this  time  both  inoculations  proceeded  very 
regularly,  but  slowly,  so  that  on  the  seventh  day  they  appeared  to  be  inflamed  in  an  equal  degree,  the  ex¬ 
tent  of  the  inflammation  not,  exceeding  the  tenth  of  an  inch  in  diameter.  Eighth  day.* — He  has  pain  in  the 
axilla.  Tenth  day. — Both  tumors  are  approaching  to  suppuration.  They  are  of  the  same  form,  and  at 
tended  with  an  equal  degree  of  efflorescence.  Eleventh  day. — He  complains  of  headache;  the  red  tinge 
now  extends  in  a  circular  form,  and  includes  both  tumors.  Thirteenth  day. — There  appears  more  tension 
and  pain  at  the  variolous  tumor  than  at  the  other,  but  the  latter  tumor  is  more  prominent.  Fifteenth  day. 
Both  tumors  began  to  dry,  and  no  inconvenience  followed.  This  boy  made  no  other  complaint,  during  the 
process  of  infection,  than  of  uneasiness  in  the  axilla,  followed  by  a  slight  headache,  of  very  short  dura¬ 
tion;  however,  on  the  seventeenth  day,  four  small  pustules  appeared,  viz  :  one  upon  his  nose,  one  upon  his 
thigh,  and  two  on  his  head  ;  none  of  which  suppurated.  This  case  strikingly  resembles  that  of  Richard 
Payne,  on  which  the  pustules  did  not  appear  till  the  arm  scabbed. 

SIXTH  CASE. 

Jane  Collingridge,  a  healthy,  active  girl,  seventeen  years  of  age.  Third  day. — The  inoculated  part  began 
to  be  elevated  anil  inflamed.  Fifth  day. — It  was  vesicated,  and  attended  with  itching.  She  was  inoculated 
with  variolous  matter  in  the  right  arm,  the  former  inoculation  having  been  in  the  left.  Eighth  day. — The 
whole  tumor  is  much  increased  in  all  dimensions  ;  its  form  is  perfectly  circular,  and  it  appears  ot  a  lemon- 
colored  tint.  She  now  complains  of  a  stiffness  across  her  arms,  and  of  a  pain  in  the  axilla  ;  the  puncture  in 
the  right  arm  begins  to  be  elevated  and  inflamed.  Eleventh  day. — She  complains  of  headache  and  pains 
about  the  loins  ;  the  tumor  produced  by  the  cow  pox  matter  is  now  more  inflamed  at  the  margin,  which  is 
beset  with  minute  confluent  pustules;  the  variolous  tumor  is  also  advanced  to  a  state  of  vesication  ;  and  she 
reports,  that  last  night  both  axillas  were  painful.  Twelfth  day _ She  continues  indisposed  ;  the  tumor  is 


*Here  as  well  as  in  the  subsequent  cases,  where  the  patient  was  twice  inoculated  on  different  days,  I  date 
he  time  from  the  first  inoculation . 


* 


99 


Cow  Pox :  William  Woodville,  M.  /). 


surrounded  by  an  extensive  efflorescence  ;  the  variolous  tumor  is  of  a  deeper  red  color.  Thirteenth  day. — 
The  cow-pox  tumor  is  subsiding  and  forming  a  scab  ;  that  of  the  small-pox  is  efflorescent ;  her  headache 
continues  ;  pain  in  the  right  axilla ;  several  pustules  appear.  Fifteenth  day. — There  are  small  pustules 
round  the  edges  of  the  variolous  tumor;  more  pustules  appear  scattered  over  the  face,  body,  and  limbs. 
Seventeenth  day. — The  scab  over  the  cow-pox  tumor  is  in  a  state  of  suppuration  ;  she  complains  of  a  sore 
throat ;  the  number  of  pustules  is  now  from  one  to  two  hundred,  in  no  respect  differing  Irom  variolous  pus¬ 
tules  of  the  mild  sort.  From  this  time  both  the  tumors  gradually  healed,  and  the  pustules  dried  at  the 
usual  time. 

SEVENTH  CASE. 

Ann  Pink,  a  tall  girl,  of  a  brown  sallow  complexion,  aged  fifteen  years.  This  girl  was  inoculated  with 
variolous  matter,  on  the  fifth  day,  in  the  same  manner  as  Colliugridge,  and  both  tumors  proceeded  to  ma¬ 
turation,  though  more  slowly  than  in  that  case  Neither  of  the  tumors  began  to  scab  till  the  seventeenth 
day,  when  they  resembled  each  other  so  perfectly  that  the  one  could  not  easily  be  distinguished  from  the 
other.  She  had  no  pain  in  either  axilla,  nor  made  any  complaint  during  the  whole  progress  of  the  infec¬ 
tion,  neither  did  pustules  appear  upon  her.  ^ 

The  only  other  persons  whom  I  first  inoculated  with  the  matter  of  cow-pox,  and  on  the  fifth  day  after¬ 
wards  with  variolous  matter,  were  William  Harris,  William  Bunker  and  James  Crouch. 

EIGHTH  CASE. 

William  Harris,  twenty -one  years  of  age,  of  a  tall  and  slender  make,  and  of  a  delicate  constitution,  was 
inoculated  January  24  with  the  matter  of  cow-pox  taken  from  the  arm  of  Sarah  Rice,  who  received  the  dis 
ease  by  milking  the  cows.  Third  day. — The  inoculated  part  was  evidently  elevated  and  inflamed.  Fifth 
day. — It  advanced  to  vesication,  and  a  sensation  of  itching  was  perceived  in  the  part ;  he  was  this  day  in¬ 
oculated  with  variolous  matter.  Ninth  day. — The  tumor  of  the  first  inoculation  presents  prominent  cailous 
edges  with  but  very  little  redness  ;  its  centre  is  depressed  and  contains  a  lymphatic  fluid;  he  perceives  a 
tenderness  in  the  axilla;  the  variolous  tumor  is  considerably  inflamed  and  vesicated,  and  itches  more  than 
the  other.  Next  day  a  pain  was  perceived  in  the  axilla  of  the  arm,  in  which  the  variolous  matter  was  in¬ 
serted,  as  well  as  in  the  other.  Twelfth  day. — Redness  of  the  cow-pox  tumor  is  going  off ;  but  that  of  the 
variolous  still  spreads  with  an  irregular  margin.  Fourteenth  day. — Several  pustules  appear.  The  cow- 
pox  tumor  is  now  dry  at  the  centre,  but  its  surrounding  edges  appear  of  a  blucish  tinge,  and  still  abound 
with  ichorous  matter.  The  variolous  tumor  is  much  inflamed,  and  beset  with  confluent  pustules  at  its 
edges  ;  its  centre  is  depressed  and  of  a  dark  hue.  Nineteenth  day. — The  cow-pox  tumor  has  formed  into  a 
dry  scab,  with  a  fiuely  polished  surface,  and  of  a  mahogany  brown  color  ;  the  variolous  tumor  is  in  a  puru¬ 
lent  state,  with  an  extensive  inflammation  at  the  margin;  the  pustules  are  about  300  in  number,  very  large, 
and  all  in  a  state  of  maturation.  From  ibis  time  all  the  effects  of  inoculation  went  off'  gradually  ;  he  never 
complained  of  headache,  nor  of  any  febrile  symptom  during  the  whole  progress  of  the  disease. 

NINTH  CASE. 

William  Bunker,  a  strong,  healthy  boy,  fifteen  years  of  age,  was  inoculated  in  his  left  arm,  on  the  same 
day,  and  with  matter  from  the  same  person  as  Harris.  Third  day. — The  inoculated  part  was  elevated  and 
reddened  Fifth  day. — The  inflammation  was  much  increased  ;  he  was  now  inoculated  in  bis  right  arm  with 
variolous  matter.  Eighth  day. — The  tumor  upon  his  left  arm  is  much  elevated,  aud  the  vesication  consid¬ 
erable  since  the  sixth  day  ;  he  now  complains  of  pain  in  the  axilla  and  of  headache.  The  pustule  on  the 
right  arm  advances  very  slowly  Tenth  day _ The  pain  in  the  axilla  aud  the  headache  continue.  The  tu¬ 

mor  of  the  left  arm  begins  to  scab  in  the  centre,  and  is  surrounded  with  a  red  tinge  of  considerable  extent. 
The  tumor  on  the  right  arm  now  also  presents  a  red  tinge  of  a  familiar  appearance,  but  not  of  half  the  ex¬ 
tent.  The  tumor  on  the  right  arm  now  also  presents  a  red  tinge  of  a  similar  appearance,  but  not  of  half 
the  extent;  its  center  is  in  a  state  of  vesication,  and  its  edges  studded  with  small  pustules  ;  his  headache  is 
not  entirely  gone  off.  Twelfth  day. — The  red  tinge  surrounding  the  tumor  on  the  left  arm  has  disappeared, 
except  a  narrow  ring  at  its  outer  border  the  tumor  on  the  right  arm  is  depressed  at  the  centre,  where  it  is 
also  of  a  livid  color ;  its  edges  are  hard  and  inflamed;  he  now  discovers  two  or  three  pustules  upon  his 
body.  Seventeenth  day. — The  matter  of  both  tumors  is  almost  wholly  formed  into  a  dry  incrustation ;  no 
more  pustules  have  appeared  ;  one  upon  his  hip  has  maturated.  Twentieth  day  — Both  tumors  are  perfectly 
scabbed  ;  that  upon  his  left  arm  appears  browner  and  smoother  than  the  other. 

TENTH  CASE. 

James  Crouch,  seven  years  old,  inoculated  on  the  same  day  as  the  last  patient  with  matter  taken  from  the 
same  girl,  and  with  variolous  matter  five  days  afterward.  Fifth  day. — The  inoculated  part  was  considera¬ 
bly  elevated  and  inflamed.  Ninth  day. — The  cow-pox  tumor  is  much  advanced;  the  pellicle  filled  with 
ichor;  the  marginal  inflammation  not  considerable  ;  the  variolous  puncture  now  displays  a  small  red  speck, 
which  begins  to  spread.  Eleventh  day. — The  cow-pox  tumor  exhibits  an  extensive  efflorescence,  or  red 
stain,  upon  the  surrounding  skin,  and  its  centre  begins  to  dry;  tbe  variolous  tumor  is  spreading  a  little,  and 
in  a  state  of  vesication.  Fourteenth  day. — Pain  in  the  axilla  is  now  produced  by  the  cow-pox  tumor,  which 
is  drying  at  the  centre;  the  variolous  tumor  is  now  efflorescent,  but  not  to  half  the  extent  of  the  other. 
From  this  time  the  tumors  quickly  healed,  no  eruption  took  place,  and  no  farther  inconvenience  was  experi¬ 
enced. 

ELEVENTH  AND  TWELFTH  CASES. 

Thomas  Fox,  aged  twenty-five,  and  John  Dennis,  twenty-three  years  of  age,  both  strong  men,  and  accus 
tomed  to  hard  labor,  were  inoculated  on  the  22d  of  January  with  variolous  matter,  and  on  the  following  day 
with  cow  pox  matter,  taken  from  the  arm  of  Sarah  Rice.  In  both  these  cases,  the  first  inoculation  was  per¬ 
formed  by  two  punctures  at  the  distance  of  two  inches  from  each  other,  aud  the  latter  by  one  puncture  at 
the  same  distance  from  the  two  former.  The  local  effects  and  appearances  of  the  inoculation  were  very 
similar  iu  both  these  men  ;  the  cow-pox  tumors  seemed  to  advance  equally  with  those  of  the  variolous,  and 
bore  a  strong  resemblance  to  them  ;  the  former,  however,  were  more  elevated  and  circumscribed  ;  for  about 
the  ninth  day  the  variolous  tumors  became  angulated  or  ragged  at  the  margin,  which  was  not  so  conspicu¬ 
ous  as  the  others,  though  both  had  small  confluent  pustules  at  their  margins.  Those  of  the  cow-i>ox  also 
sooner  healed,  and  formed  a  smoother  scab.  The  eruptive  fever  came  on  about  the  eighth  day  with  Dennis, 
but  not  till  the  tenth  with  Fox;  the  former  had  more  than  300  pustules;  and  the  latter  about  100 ;  allot 
which  were  in  every  respect  similar  to  variolous  pustules. 


I 00  Cow  Pox:  William  Woodvtlle,  M.  1). 


THIRTEENTH  AND  FOURTEENTH  CASES. 

John  Talley,  fourteen,  and  Thomas  Brown,  fifteen  years  old,  were,  January  25th ,  inoculated  with  vario 
lous  matter  in  the  left  arm,  and  the  following  day  they  were  both  inoculated  in  the  right  arm  with  the  matter 
of  cow-pox,  taken  from  the  ai  ms  of  Mary  and  Elizabeth  Payne,  (see  cases  first  and  second) .  The  progress 
of  both  the  infections  on  the  aims  of  these  boys  was  perfectly  regular  and  equal  throughout.  On  the  sev¬ 
enth  day  all  the  tumors  were  considerably  inflamed  and  in  a  state  of  vesication,  attended  with  itching. 
Brown  also  at  this  time  complained  of  a  pain  in  each  axilla ;  but  with  .Talley  the  pain  was  confined  to  the 
left  till  the  next  day,  when  both  arm-pits  were  affected.  Tenth  day. — They  both  complained  of  headache 
and  of  pains  about  the  loins ;  these,  however,  were  very  slight,  and  no  further  indisposition  ensued.  On 
the  evening  of  the  twelfth  day  some  pustules  appeared  upon  Brown,  but  upon  Talley  they  did  not  appear 
till  the  fourteenth  day ;  the  former  had  in  all  about  thirty,  and  the  latter  only  six,  ail  of  which  were  ap¬ 
parently  variolous.  The  cow-pox  tumors  were  more  elevated  at  the  edges  and  less  depressed  at  the  centre 
after  the  ninth  day  than  those  of  the  variolous;  and  they'  eventually  formed  a  smoother  and  browner  scab, 
as  in  the  case  of  Fox  and  Dennis. 

January  30th. — William  Mundy,  Elizabeth  George  and  Sarah  Butcher  were  inoculated  by  two  punctures 
with  the  matter  of  cow-pox,  taken  from  the  arm  ot  Collingridge,  (Case  6th.) 


FIFTEENTH  CASE. 

William  Mundy7,  a  strong  laboring  man,  aged  twenty-five  years,  was  inoculated  as  above  described  by  two 
punctures  in  his  left  arm.  The  local  infection  of  both  punctures  advanced,  and  the  inflammation  and  its 
eff&ts  proceeded  rapidly,  so  that  on  the  eighth  day  he  complained  of  uneasiness  in  his  axilla,  and  of  pain 
in  the  head  and  loins,  which  continued  about  two  days;  the  tumors  were  considerably  elevated,  and  their 
margins  much  inflamed.  Thirteenth  day  .—They  Were  surrounded  with  an  extensive  redness,  in  the  form 
of  an  halo,  and  beginning  to  scab  at  the  centre  ;  the  edges  continued  circular,  well  defined,  and  elevated. 
Fourteenth  day.  Several  pustules  appeared  upon  his  neck  arid  back  but  disappeared  in  two  or  three  days 
Without  suppurating.  He  was  this  day  inoculated  with  variolous  matter,  but  it.  produced  no  other  effect 
than  a  little  redness  of  two  or  three  days  duration. 

SIXTEENTH  CASE. 

Elizabeth  George,  a  strong  woman,  twenty-five  years  old,  was  inoculated  in  the  same  manner,  and  on  the 
same  dav  above  mentioned^  with  cow-pox  matter  taken  from  the  same  person.  The  punctures  quickly 
rose,  but  the  inflammation  was  inconsiderable  till  the  sixth  day,  when  vesication  and  itching  commenced. 
Ninth  day. — Has  no  pain  in  the  axilla,  but  complains  of  headache  and  pain  in  the  loins  Eleventh  day.— 
Her  pains  continue  ;  pulse  quick  ;  the  central  pellicle  of  the  tumors  is  extending,  and  replete  with  a  watery7 
humor  ;  the  margins  swollen  and  red.  Thirteenth  day  — The  same  appearances  continue  Fifteenth  day. — 
The  symptoms  are  abated ;  says  she  has  no  other  complaint  than  a  giddiness  of  the  head  ;  the  inflammation 
at  the  margin  of  the  tumors  is  greatly7  abated  ;  the  matter  in  the  centre  is  beginning  to  dry  ;  some  pustules 
appear  on  the,  face .  Sixteenth  day.— She  makes  no  complaint ;  more  pustules  show  themselves  ;  the  tumors 
appear  circular,  with  the  centre  equally  elevated  as  the  edges,  and  exhibiting  an  uniform,  smooth  surface, 
which  is  becoming  hard.  Eighteenth  day —More  pustules  have  appeared;  the  tumors  are  scabbing,  and 
the  surrounding  redness  is  almost  wholly  gone.  Twentienth  day. — Her  face  is  swelled  ;  the  pustules  ate 
very  sore,  and  iu  a  purulent  state  ;  their  number  is  five  hundred  and  thirty,  and  two  in  the  throat  are  a  little 
troublesome.  Twenty-fifth  day — The  pustules  in  a  state  of  desquamation.  She  was  now  inoculated  with 
variolous  matter,  which  produced  no  effect.  The  scabs  at  the  inoculated  parts  were  of  that  brown,  smooth 
kind  peculiar  to  the  cow-pox. 

SEVENTEENTH  CASE. 

Sarah  Butcher,  a  healthy  girl,  thirteen  years  old,  was  inoculated  with  the  matter  ot  cow-pox  at  the  same 
timeand  in  the  same  manner  as  above  mentioned.  Sixth  day.— The  tumors  were  much  elevated,  theinflamma- 
tion  inconsiderable;  the  vesication  fully  formed,  and  attended  with  itching  Ninth  day. — There  was  a 
slight  efflorescence  around  the  tumors,  uneasiness  iu  the  axilla,  headache,  pain  in  the  loins.  Eleventh  day. — 
Suppuration  at  the  inuer  edges  of  the  tumor,  redness  at  the  outer  edge  very  exrensive.  Fourteenth  day. — 
Tumors  scabbing  ;  no  eruption  ;  complains  of  pain  in  her  bowels  and  diarrhoea.  Sixteenth  day — No  com¬ 
plaint,  central  part  of  tumor  scabbed  ;  inflammation  still  surrounding  the  edges.  She  was  inoculated  this 
day  with  variolous  matter.  Eighteenth  day. — The  redness  gone  off,  leaving  a  red  tinge  at  its  outer  margin. 
The  variolous  matter  produced  a  little  redness,  which  disappeared  iu  two  days 

January  31st. — Thomas  Wife,  aged  fourteen,  and  Sarah  Price,  aged  thirteen  years,  were  inoculated  with 
the  matter  of  cow-pox,  taken  from  Mathew  Bedding,  and  at  the  same  time  with  variolous  matter,  but  the 
latter  inoculations  were  the  following  day  prevented  by  applying  the  concentrated  acid  of  vitrol  to  the 
punctures. 

EIGHTEENTH  CASE. 

Thomas  Wife,  above  mentioned.  Fifth  day. — The  inoculated  part  was  considerably  inflamed  and  vesi¬ 
cated.  Eighth  day. — The  tumor  advances  with  much  marginal  redness,  and  a  pain  iu  the  axilla  is  per¬ 
ceived.  Twelfth  day. — Pain  in  the  axilla  continued  two  days.  He  has  no  other  complaint.  The  centre  of 
the  tumor  is  forming  a  scab,  but  is  surrounded  with  an  appearance  like  areola  papilla?,.  Two  pustules  were 
discovered  upon  his  body  this  day,  and  two  more  appeared  on  the  fifteenth  day,  but  none  of  them  became 
purulent.  The  tumor  upon  his  arm  had  at  the  time  formed  a  hard,  smooth  scab. 

NINETEENTH  CASE. 

Sarah  Price,  inoculated,  as  above  stated,  in  her  left  aim  ;  on  the  same  day  was  inserted  in  her  right  arm 
cow-pox  matter,  taken  from  a  pustule  from  Buckland.  Fifth  day. — There  was  a  redness  of  elevation  at  the 
two  punctures  of  each  arm,  but  in  consequence  of  the  caustic  effects  of  the  vitriolic  acid  none  at  the  vario¬ 
lous  puncture.  Eighth  day. — Both  tumors  were  advanced;  vesication  and  a  considerable  degree  of  inflam¬ 
mation,  especially  in  that  on  the  left  arm.  She  now  complains  of  rigor  and  of  pain  in  the  left  axilla. 
These  symptoms,  together  with  a  headache,  continues  twro  days.  Three  pustules  have  appeared  upon  her 
face  and  neck,  and  two  days  afterwards  three  others,  none  of  which  suppurated.  This  girl,  as  well  as 
Thomas  Wife,  was  constantly  exposed  to  the  small  pox  during  the  progress  of  their  inoculation . 


Cow  Vox :  William  1 VoodviUe,  M.  D. 


101 


TWENTIETH  CASE. 

Thomas  Dorset,  inoculated  February  1st,  with  the  matter  of  cow-pox,  taken  from  the  arm  of  Jane  (Jol- 
lingridge  (see  case  six) .  Seventh  day.— The  inoculated  part  was  much  elevated  and  in  a  state  of  vesication, 
attended  with  the  usual  degree  of  redness.  Eleventh  day. — Last  night  he  perceived  an  uneasiness  in  his 
axilla,  and  he  now  complains  of  pain  about  his  loins  ;  the  tumor  encircled  by  an  extensive  efflorescence. 
Thirteenth  day. — The  tumor  scabbing  at  the  centre  He  was  inoculated  this  day  with  variolous  matter. 
The  variolous  inoculation,  produced  no  effect.  About  the  twelfth  day  this  man  had  four  or  five  pustular 
appearances  which  he  called  pock,  but  they  seemed  to  me  more  like  common  pimples  than  variolous  pus¬ 
tules. 

TWENTY-FIRST  CASE. 

John  Keys,  twenty-five  years  old,  inoculated  February  6,  with  matter  of  cow-pox  taken  from  the  arm  of 
James  Crouch.  On  the  fourth  day  the  inoculated  part  was  considerably  inflamed,  and  affected  with  a  sen¬ 
sation  of  itching;  but  from  this  time  the  redness  gradually  disappeared,  and  was  entirely  gone  on  the 
ninth  day,  when  he  was  inoculated  with  variolous  matter  in  both  arms,  but  without  effect.  On  the  tenth 
day,  however,  he  complained  of  pain  in  his  head  and  loins,  with  which  he  was  affected  three  days,  but 
no  eruption  ensued. 

TWENTY- SECOND  CASE. 

Edward  Turner,  a  strong  man,  twenty-four  years  of  age.,  inoculated  by  two  punctures  with  the  matter 
of  cow  pox  taken  from  the  arm  of  James  Crouch  (Case  Tenth)  February  5th.  Seventh  day. — The  tumors 
were  much  advanced,  in  a  state  of  open  vesication,  and  attended  with  itching.  Twelfth  day  — They  be¬ 
gan  to  dry  in  the  centre,  but  the  margins  were  of  a  dry  red  color,  and  studded  with  minute  vesiculas ; 
lie  now  complains  of  pain  in  the  axilla,  stiffness  of  his  neck  and  pain  in  the  loins.  Fourteenth  day. — 
Headache  and  pains  in  the  loins  continue  ;  the  inner  edges  of  the  tumors,  are  distended  with  an  ichorous 
fluid.  Sixteenth  day . — Complaints  of  headache  and  sore  throat;  next  day  about  100  pustules  appeared, 
many  of  which  were  very  small.  Nineteenth  day. — He  has  no  complaint ;  the  number  of  the  pustules 
now  amounts  to  about  220;  all  of  them  afterwards  suppurated.  On  the  twenty-third  day  he  was  inoculated 
with  the  variolous  matter,  which  produced  no  effect, 

TWENTY-THIRD  CASE. 

Hannah  Morgan,  a  strong  child,  one  year  old,  was  inoculated  with  the  matter  of  cow-pox  taken  from 
the  arm  of  James  Crouch,  February  5.  Fifth  day.- — The  inoculated  partis  much  elevated  and  inflamed. 
Seventh  day  — The  tumor  contains  ichor,  and  the  redness  and  elevation  are  greatly  increased;  yesterday 
she  became  feverish,  and  last  night  was  sick  and  vomited ;  her  skin  at  this  time  is  hotter  than  usual. 
Fourteenth  day  — The  febrile  symptoms  continued,  and  at  times  were  very  severe,  till  the  tumor  is  now 
scabbing.  She  was  afterwards  inoculated  with  variolous  matter,  but  it  only  produced  a  transient  redness 
in  the  part. 

TWENTY- FOURTH  CASE. 

Tane  West,  twenty-one  years  of  age,  was  inoculated  on  February  6th  with  the  matter  of  cow-pox,  taken 
from  the  arm  of  Sarah  Butcher.  Seventh  day. — The  inoculated  part  was  considerably  elevated  and  in¬ 
flam  al ;  the  vesication  was  also  extensive  and  attended  with  itching.  Ninth  day. — She  complained  of  head¬ 
ache,  and  next  day  of  a  pain  in  the  axilla  and  upon  her  shoulder,  attended  with  rigors  and  shivering;  the 
border  of  the  tumors  appeared  of  a  deep  red,  and  its  inner  edges  contained  an  ichorous  matter.  Thirteenth 
day. — Yesterday  an  efflorescense  appeared  around  the  tumor.  She  complains  of  a  sore  throat,  and  says  she 
has  a  pain  across  her  chest.  Fifteenth  day. — Two  pustules  have  appeared  upon  her  side;  the  tumor  be¬ 
gins  to  dry.  She  makes  no  complaint.  Seventeenth  day.— Twenty  pustules  appeared,  all  of  which  sup¬ 
purated.  Twenty-third  day.— The  variolous  inoculation  produced  no  inflammation. 

TWENTY-FIFTH  CASE. 

Ann  Bumpus,  aged  twenty  years,  was  inoculated  February  6  with  the  matter  of  cow-pox,  taken  from  the 
arm  of  Sarah  Butcher.  The  appearances  of  the  inoculated  part  in  this  girl’s  arm  corresponded  in  every 
respect  with  those  stated  in  West’s  case.  Eighth  day. — She  complained  of  headache.  Tenth  day. — Pain 
of  the  head  and  loins  ;  shivering.  Eleventh  day. — Two  or  three  pustules  appear  upon  her  face.  Thirteenth 
day  .—Pains  continue';  more  pustules  appear.  Fifteenth  day. — No  complaint;  the  pustules  were  counted 
and  found  to  be  310,  resembling  those  of  the  small-pox.  Seventeenth  day  .—Complains  of  sore  throat. 
Nineteenth  day — Pustules  drying.  Twenty-second  day. — Inoculated  with  the  matter  of  small-pox,  but  no 
inflammation  was  produced  by  it. 


TWENTY-SIXTH  CASE. 

Thomas  Slade,  twenty  years  of  age,  was  inoculated  with  the  matter  of  cow-pox  taken  from  the  arm  of 
William  Mundy,  February  6.  On  the  eighth  day  the  inoculated  part  was  much  elevated  and  in  an  advanced 
state  of  vesication.  He  complained  of  headache  and  pain  in  the  axilla;  and  on  the  next  day  of  a  pain  in 
the  loins.  Eleventh  day. — Pains  abated  ;  three  or  four  pustules  appear  ;  the  tumor  is  bordered  with  small 
confluent  vesicles.  Fourteenth  day. — No  complaints;  tumor  beginning  to  scab.  Nineteenth  day. — The 
centre  of  the  tumor  formed  a  biown,  hard  scab.  The  pustules  do  not  suppurate  and  are  receding.  Twenty- 
second  day. — He  was  inoculated  with  the  matter  of  small-pox.  which  produced  a  redness  for  two  or  three 
days,  and  afterwards  gradually  disappeared. 

TWENTY-SEVENTH  CASE. 

Frances  Jewel,  a  healthy  young  woman,  twenty  years  of  age,  who  had  undergone  the  small  pox  by  inoc¬ 
ulation  when  a  child,  was  inoculated  with  the  matter  of  cow-pox  taken  from  the  arm  of  Sarah  Butcher, 
February  5,  The  inoculated  part  advanced  with  a  tumor  equal  in  extent  and  duration  to  that  in  the  case 
last  mentioned  ;  on  the  ninth  day  headache  and  pains  of  the  loins  came  on,  and  continued  two  or  three  days. 
The  tumor  begau  to  scab  on  the  thirteenth  day,  hut  no  pustules  appeared.  She  was  afterwards  inoculated 
with  variolous  matter,  and  also  with  that  of  the  cow-pox,  neither  of  which  produced  any  inflammation  . 


302 


Cote  Pox  :  William  Woodville ,  M.  1). 


TWENTY-EIGHTH  CASE. 

Charlotte  Fisk,  four  months  old,  was.  on  February  the  13tli,  inoculated  with  the  matter  of  cow-pox,  taken 
from  the  arm  of  Frances  Jewel.  In  this  child  the  local  disease  proceeded  very  regularly.  She  had  became 
indisposed  on  the  eighth  day,  and  continued  feverish  for  three  or  four  days,  when  about  forty  pustules  ap¬ 
peared  ;  but  the  greatest  part  of  these  pustules  did  not  proceed  to  suppuration.  The  mother  of  the  child 
labored  under  the  natural  small  pox,  and  was  covered  with  pustules  in  a  purulent  state  at  the  time  her  child 
was  inoculated ;  yet  the  infant  was  suckled  by  her  during  the  whole  course  of  the  disease,  and  was  fre¬ 
quently  seen  besmeared  with  variolous  pus.  Whence  it  would  appear  that  the  vaccine  infection  not  only 
prevents  but  actually  supersedes  the  casual  small-pox. 

TWENTY-NINTH  CASE. 

James  Tarrent,  nineteen  years  old,  was,  on  the  16th  day  of  February,  inoculated  with  the  matter  of  cow- 
pox,  taken  from  a  pustule  upon  Elizabeth  George.  In  this  case  the  inflammation  at  the  inoculated  part, pro¬ 
ceeded  very  rapidly,  and  was  more  extensive  than  usual  on  the  sixth  day ;  but  from  this  time  it  began  to  re  - 
cede,  and  was  entirely  gone  on  the  tenth  day,  only  a  small  dry  scab  at  the  puncture  being  left.  He  was 
now  inoculated  with  variolous  matter,  w  hich  did  not  produce  any  inflammation  whatever.  I  consider  this 
man  one  of  the  few  whose  constitutions  cannot  be  effected  either  by  the  virus  of  the  cow-pox  or  the  small¬ 
pox.  It  is  true  he  complained  of  headache  about  the  ninth  day,  but  I  should  not  be  disposed  to  attribute 
this  symptom  to  the  inoculation. 

THIRTIETH  CASE. 

William  Hull,  aged  eleven  years,  was,  on  tlio  8th  day  of  February,  inoculated  with  the  matter  of  cow 
pox  taken  from  the  arm  of  Sarah  Butcher.  Seventh  dav. — The  tumor  at  the  inoculated  part  is  advanced  in 
the  usual  manner,  and  he  this  day  complains  of  headache.  Tenth  day. — His  headache  and  pains  in  the 
loins  continue,  and  several  pustules  now  appear  upon  him.  Twelfth  day.— The  pains  are  gone  off  and  more 
pustules  appeared.  Fifteenth  day  .—The  pustules  amount  to  about  200.  They  vary  much  in  size,  and  are 
proceeding  to  maturation.  Eighteenth  day.  He  was  inoculated  with  variolous  matter,  which  produced  no 
effect.  . 

THIRTY-FIRST  AND  THIRTY-SECOND  CASES. 

Febrnarv  8th,  Hannah  Hull,  aged  thirteen  years,  and  Sarah  Hull,  eight,  years  old,  were  inoculated  with 
the  matter  of  cow-pox  taken  from  Sarah  Butcher.  These  two  sisters  had  the  disease  rather  more  favorably 
than  their  brother  William  Hull,  for  the  inoculated  part,  was  in  both  sni  rounded  by  an  efflorescence  on  the 
eleventh  day,  and  the  number  of  pustules  upon  the  third  was  not,  equal  to  that,  of  their  brother’s,  nor  were 
the  eruptive  symptoms  of  half  the  duration  of  his.  On  the  twentieth  day  they  wrere  inoculated  for  the 
small  pox,  but  no  disease  ensued. 


THIRTY-THIRD  CASE. 

George  Heed,  aged  fifteen  years,  was  inoculated  with  the  matter  of  cow'-pox  taken  from  the  arm  of  T. 
Jessel,  February  14th .  The  inoculated  part  tumified  in  the  usual  manner ;  he  complained  of  headache  on 
the  eighth  day,  and  this  symptom  continued  with  occasional  intermissions  till  the  13th  day.  Some  pustules 
began  to  appear  about  the  11th,  aud  the  eruption  was  completed  on  the  fourteenth  day.  They  were  in 
number  about  seventy  some  of  which  were  very  small,  but  they  all  maturated  in  a  favorable  manner.  He 
was  aftewards  inoculated  with  variolous  matter,  which  formed  a  pustular  appearance;  but  no  disorder  was 
produced,  Fiances  I’edder,  Amelia  Hoole,  George  Hickland  and  Elizabeth  Morton,  were  inoculated  on 
February  13th  and  14th  with  cox-pox  matter  taken  from  the,  arm  of  Sarah  Price,  who  was  inoculated  from 
a  pustule  on  Buckland  (see  case  three). 

THIRTY-FOURTH  CASE. 

Frances  Pedder,  a  child,  eleven  months  old.  The  inoculated  part  was  gradually  elevated  and  inflamed. 
Eigtii  day.— The  eruptive  symptons  supervened  and  she  continued  feverish  till  the  thirteenth  day,  when  sev¬ 
eral  pustules  appeared.  The  tumor  began  to  scab  and  the  number  of  pustules  then  upon  her  was  forty,  all  of 
which  inoculated  without  becoming  purulent.  She  was  afterwards  inoculated  for  the  small-pox  without 
effect. 

THIRTY-FIFTH  CASE. 

Amelia  Hoole,  five  months  old,  was  inoculated  as  above  described.  The  local  tumor  advanced  in  the  us- 
ual  manner.  Seventh  day.  She  became  feverish,  and  several  small  pustules  appeared  at  the  border  of  the 
tumor.  Tenth  day. — She  continued  slightly  indisposed  since  the  last  report,  and  nine  pustules  are  now 
visible  upon  her  body  and  extremities.  Fourteenth  day  — The  pustules  amount  to  102  in  number,  and  form 
yellowish  scabs.  Eighteenth  day. — The  inoculated  part  was  perfectly  healed;  the  pustules  appeared  in  a 
state  of  desquamation.  She  was  at  this  time  inoculated  with  variolous  matter,  but,  without  effect. 


THIRTY-SIXTH  CASE. 

George  Hickland.  six  months  old,  inoculated  from  the  person  above  mentioned.  The  eruption  symptoms 
in  this  child  were  less  severe,  and  of  shorter  duration  than  in  the  last  case.  However  the  number  of  pus¬ 
tules  which  appeared  amount  to  300,  but,  only  about  one-third  of  them  suppurated.  This  patient  also  re¬ 
sisted  the  infection  of  the  small  pox  by  inoculation. 

THIRTY-SEVENTH  CASE. 

Elizabeth  Morton,  nine  months  old,  was  more  severely  disordered  than  any  of  the  four  children  inocu¬ 
lated  with  the  matter  taken  from  Sarah  Price.  The  fever  continued  with  some  degree  of  violence  from 
the  seventh  to  the  fifteenth  day,  and  the  number  of  pustules  amounted  to  200.  On  the  twentieth  day  she 
was  inoculated  with  variolous  matter  without  effect. 


Cow-Pox;  William  Woodville,  M.  D. 


103 


THIRTY-EIGHTH  CASE. 

L.  Davy,  aged  eleven  weeks,  was  on  February  19th  inoculated  with  the  matter  of  cow-pox  taken  from 
the  arm  of  Charlotte  Fisk.  This  child  had  the  disease  very  favorably.  On  the  tenth  day  the  t-umor  was 
surrounded  by  efflorescerce,  and  her  skin  was  a  little  hotter  than  usual  during  that  day  only.  On  the  thir¬ 
teenth  day  one  pustule  appeared  near  to  the  inoculated  part,  and  r  wo  upon  her  forehead,  which  were  all  she 
had.  She  was  afterwards  inoculated  for  the  small-pox  without  effect. 


THIRTY-NINTH  CASE. 

Maria  Murrell,  aged  four  months,  was  inoculated  with  matter  taken  from  the  same  person  and  on  the  same 
day  as  Davy.  Fifth  day. — The  inoculated  part  was  much  elevated  and  inflamed .  On  the  evening  of  the 
eighth  day  she  vomited.  Tenth  day.— The  tumor  was  surrounded  by  a  very  extensive  efflorescence,  and  she 
became  hot  and  restless.  Twelfth  day. — She  seemed  free  from  fever,  and  about  twenty  pustules  appealed 
upon  her.  Fourteenth  day. — The  inflammation  upon  the  arm  was  gone  off,  and  the  pustules  seemed  to  be 
scabbing.  The  subsequent  inoculation  of  the  small-pox  as  upon  the  others,  produced  no  effect  upon  this 
patient. 

A  cow  kept  by  Professor  Coleman,  at  the  Veterinary  College,  was  inoculated  on  its  teat  with  the  matter 
ol  cow-pox  taken  from  the  arm  of  James  Crouch,  which  produced  the  disease  in  the  cow  (see  case  ten)  A 
man-servant,  by  milking  this  cow,  was  also  affected  with  an  extensive  tumor  upon  his  thumb  ;  this  soon  ac¬ 
quired  a  livid  blue  color,  and  was  attended  with  a  considerable  degree  of  fever  for  several  day  s,  and  with  a 
rash  upon  his  ankles  and  feet. 

With  the  mat terlproduced  in  the  nipple  of  this  cow  were  inoculated  Martha  Streeton,  James  Smith  and 
George  Meacock. 

FORTIETH  CASE. 


Martha  Streeton,  aged  twenty -two years,  was  on  the  1  Pth  of  February,  inoculated  with  the  matter  above 
mentioned.  The  inoculated  part  tumifiedin  the  usual  manner,  and  on  the  ninth  day  she  complained  of 
headache,  and  afterwards  of  a  pain  in  the  axilla.  The  headache  and  pain  in  the  loins  continded,  but  not 
with  severity,  for' five  or  six  days.  Pustules  began  to  appear  on  the  twelfth,  and  the  er  uption  was  com¬ 
pleted  on  the  sixteenth  day,  when  the  number  was  about  300,  During  the  maturation  of  the  pustules,  which 
in  no  respect  differed  from  those  of  the  small-pox,  she  complained  of  her  throat  being  sore.  On  the  nine¬ 
teenth  day  this  patient  was  perfectly  well.  She  was  afterwards  inoculated  for  the  small  pox  without  effect. 


FORTY-FIRST  AND  FORTY-SECOND  CASES. 

James  Smith,  sixteen,  and  George  Meacock,  thirty  years  of  age,  were,  on  the  19tli  of  February,  inocu¬ 
lated  with  the  same  matter  as  that  mentioned  in  the  preceding  case.  The  latter  of  tin  se  patients  had  the 
disease  nearly  in  the  same  manner  as  Streeton  :  but  in  a  greater  degree,  for  Meacock’s  pustules  were  more 
numerous  anil  the  inoculated  part  did  not  exhibit  a  tumor  so  well  defined  and  elevated  as  Streeton 's  did. 
Smith’s  case  differed  widely  from  both  ;  his  arm  tumified  rapidly,  and  an  erythema  or  blush  extended 
from  the  puncture  several  inches  up  his  arm,  and  down  to  the  elbow.  The  eruptive  symptoms  began  on 
the  seventh,  and  continued  till  the  eleventh  day.  He  had  four  or  five  pustules  upon  his  face,  and  nearly  a 
hundred  upon  his  body  and  limbs,  all  of  which  matured  favorably  and  the  erysipelatous  appearance  of  the 
inoculated  part  soon  went  off,  though  no  application  was  employed  for  that  purpose.  Both  the  above 
patients  were  inoculated  with  variolous  matter,  which  produced  no  effect  upon  Meacock,  but  in  5>m ith  it  was 
followed  by  a  cutaneous  inflammation  of  several  days  continuance. 

Samuel  Fairbrotlier,  fifteen  years  old,  Richard  Calloway,  aged  nineteen  years,  James  Camplin,  aged  sev¬ 
enteen  years,  John  Turner,  eight  months  old,  and  Mary  Welsh,  three  months  old,  were  all,  on  the  '21st  and 
23d  of  February,  inoculated  with  the  matter  of  cow-pox  taken  from  the  arm  of  Edward  Turner  (see  case 
twenty -two) . 

FORTY-THIRD  CASE. 

Samuel  Fairbrotlier  began  to  be  indisposed  on  the  ninth  day,  and  had  repeatedly  slight  feverish  paroxysms 
with  pain  in  the  axilla  till  the  fourteenth  day,  when  four  small  pustules  appeared,  after  which  no  further 
complaint  ensued. 

FORTY-FOURTH  CASE. 

In  Richard  Calloway  the  inoculated  part  tumified  in  the  usual  manner,  and  on  the  ninth  day  he  first  com¬ 
plained  of  a  pain  iu  the  axilla  and  headache,  which  continued  till  the  twelfth  day,  an  extensive  bright  red 
blush  then  surrounded  the  tumor,  and  no  farther  complaint  ensued.  A  t  this  time  also  some  pustules  ap¬ 
peared,  but  their  number  never  exceeded  twenty .  He  had  been  inoculated  in  the  hand  as  well  as  in  the 
arm,  in  order  to  discover  if  the  appearance  of  the  tumor  in  a  part  constantly  exposed  to  the  air  would  be  the 
same  as  in  the  arm  covered  by  his  dress.  The  difference  was  very  evident,  for  the  tumor  upon  his  hand 
was  much  more  extensive,  of  a  more  livid  color,  and  attended  with  more  inflammation  than  the  other. 

FORTY-FIFTH  CASE. 

James  Camplin  suffered  rather  more  from  the  eruptive  complaints  than  Calloway,  and  they  continued 
with  him  a  day  longer.  However,  the  disease  gave  him  very  little  uneasiness,  and  he  had  only  thirty  pus¬ 
tules. 


FORTY-SIXTH  CASE. 

John  Turner’s  arm  was  inflamed  very  extensively,  and  he  became  feverish  on  the  eighth  dav.  Bhe  fol¬ 
lowing  day  many  pustules  appeared,  and  on  the  eleventh  day  he  was  almost  covered  with  pustules,  having 
about  1000,  These,  however,  were  perfectly  distinct,  and  they  all  maturated  favorably,  so  that  about  the 
seventeenth  day  he  was  completely  well. 


104 


Cow-Pox  ;  William  Woodville ,  M.  I). 


FORTY-SEVENTH  AND  FORTY-EIGHTH  CASES. 

Joanna  Buckley  and  Mary  Welch  had  the  disease  in  its  mildest  form.  On  the  eighth  day  an  efflorescence 
surrounded  the  inoculated  part  in  both  these  children,  and  during  this  day  only  appeared  a  little  indisposed. 
No  pustules  upon  either  of  them 

All  the  six  patients  thus  infected  with  vaccine  disease  from  E.  Turner,  were  subsequently  inoculated 
with  variolous  matter,  which  did  not  produce  any  disorder. 

February  18th,  William  Walker,  eleven  months  old;  February  24th.  Sarah  Dixon,  nineteen  years  old ; 
Thomas  Ellistone,  aged  fifteen  months;  Maria  Dunn,  aged  twenty  months;  and  James  Cummins,  aged- 
fourteen  weeks,  were  all  inoculated  with  the  matter  of  cow-pox  taken  from  the  arm  of  Hannah  Bumpus. 

FO KT Y-NJLN T H  CASE. 

♦William  Walker's  arm  tumified  in  the  usual  manner,  but  he  did  not  manifest  the  least  indisposition  dur¬ 
ing  the  course  of  the  infection  ;  neither  did  any  pustules  appear,  except  one  or  two  at  the  inoculated  part. 

FIFTIETH  CASE,  , 

Sarah  Dixon’s  arm  tumified  in  the  usual  manner,  and  on  the  tenth  day  she  began  to  complain  of  a  pain  in 
her  head  and  loins ;  this  was  followed  by  shiverings  and  a  pain  in  the  axilla  and  across  her  shoulders. 
Thirteenth  day  — The  pains  were  much  abated,  and  some  pustules  appeared.  Sixteenth  day, — She  makes 
no  complaint,  but  ot  a  soreness  of  her  throat  ;  the  eruption  is  now  completed,  and  the  number  of  the  pus¬ 
tules  is  found  to  be  174  ;  all  of  these  afterwards  maturated. 

FIFTY-FIRST  CASE. 

Thomas  Ellistone  was  feverish  from  the  sixth  to  the  eighth  dav.  when  the  tumor  was  surrounded  with 
an  extensive  efflorescence.  After  this  time  lie  had  no  ailment.  No  pustules  appeared! 

F I F TY-SECOND  CAS E . 

Maria  Dunn  was  hot  and  restless  from  the  sixth  till  the  ninth  day.  She  had  no  eruption. 

FIFTY-THIRD  CASE. 

James  Cummins  did  not  seem  the  least  disordered  from  the  inoculation,  although  the  inoculated  part  tumi- 
tied  very  considerably,  and  several  pustules  appeared  at  the  margin  of  the  tumor  on  the  eleventh  day. 

All  the  above-mentioned  persons,  inoculated  witli  tbe  matter  of  the  cow  pox,  taken  from  the  arm  of 
Bumpus.  have  been  since  inoculated  with  variolous  matter,  hut  without  effect. 

John  Giles,  twenty  years  of  age  :  Wm.  Bigg,  eighteen  years  old;  Wm.  Brians',  fifteen  years  old  ;  Sophia 
Dobinson.  five  years  old  ;  Sarah  Dobinson,  three  years  old;  and  Hannah  Dohinson,  one  year  old;  were 
inoculated  with  the  matter  of  cow-pox,  taken  from  the  arm  of  Jane  West,  February  21. 

FIFTY-FOURTH  CASE. 

.John  Giles  complained  of  headache  from  the  ninth  to  the  eleventh  day.  A  slight  soreness  of  the  throat 
came  on,  and  continued  several  days.  He  had  about  thirty  pustules. 

FIFTY-FIFTH  CASE. 

William  Bigg  also  complained  of  headache  and  sore  throat  several  days,  and  had  about  twelve  pustules. 

FIFTY-SIXTH  CASE. 


Wm.  Brians  first  complained  of  indisposition  on  the  seventh,  and  continued  somewhat  disordered  till  the 
eleventh  day.  Only  two  pustules  appeared. 

FIFTY-SE  VENTH  OASE. 

Sophia  Dobiuson’s  arm  tumified  extensively,  hut  she  made  no  complaint  during  the  whole  progress  of  the 
infection,  and  had  no  eruptions. 

FIFTY-EIGHTH  CASE. 

Sarah  Dohinson 's  case  was  in  every  respect  similar  to  that  of  her  sister  Sophia. 

FIFTY-NINTH  CASE. 

Hannah  Dobinson  suffered  as  little  from  the  disease  as  either  of  her  sisters  till  the  fourteenth  day,  when, 
according  to  her  mother’s  report,  she  was  seized  with  convulsions  for  two  or  three  hours.  She  had  no  erup¬ 
tion  . 

The  above  six  patients  have  since  been  inoculated  for  the  small-pox  without  effect. 

Mary  Greeville,  twenty  years  old;  Edward  Honey  wood,  two  years  old;  Thomas  Rood,  one  and  a  half 
years  old,  Charlotte,  Mile  fifteen  months  old;  Henry  Barber,  eleven  months  old;  John  Jenkins,  one 
month  old  ;  Thomas  Dix,  eleven  months  old  ;  Ann  Walker,  ten  months  old:  Samuel  Francis  Brough,  ten 
months  old  ;  Alexander  Towser,  eight  months  old ;  Wm.  Knighton,  eight  months  old ;  Sarah  Price,  eight 
mouths  old ;  Elizabeth  Spilsbnry,  four  months  old;  Elizabeth  May,  four  months  old  :  Mary  Ann  Sully, 
three  months  old  ;  Francis  Terry,  two  months  old  :  Wm.  Scott,  two  months  old  ;  Wm.  Johnson,  two  months 
old,  were  inoculated  with  the  matter  of  cow-pox,  taken  from  the  arm  of  Martha  Streeton,  on  February  25th. 


*  The  father  of  this  child  is  an  ing  nious  engraver  in  Rosamond  street,  Clerkenwell,  who  having  lost  a 
child  under  the  effects  of  inoculated  small-pox.  was  induced  to  inoculate  his  only  sou  for  the  cow-pox. 
The  particulars  of  the  case  are  related  by  Mr.  Walker  himselt,  in  the  Medical  arid  Physical  Journal  for 
March,  1799. 


Cow  Vox  :  William  Woodviile ,  M.  I). 


105 


SIXTIETH  CASE. 

Mary  Greenville,  on  the  ninth  d  ly,  he  nan  to  complain  of  headache,  which  continued  till  the  twelfth  day 
when  a  sore  throat  came  on,  and  gave  her  a  little  uneasiness  for  about  two  days.  She  had  thirty-live  pus¬ 
tules. 

SIXTY-FIRST  CASE. 

Edward  Honeywood  was  not  perceptibly  disordered  from  the  inoculation,  although  his  arm  was  much 
tumifiecl:  and  on  the  eleventh  day  it  exhibited  an  efflorescence.  Ko  eruption  appeared. 

SIXTY-SECOND  CASE. 

Thomas  Rood  was  feverish  from  the  seventh  till  the  tenth  day,  and  at  the  commencement  of  the  fever  he 
had  two  or  three  short  convulsive  paroxysms  ;  but  no  eruption  took  place. 

SIXTY-THIRD  CASE. 

Charlotte  Mile.  A  little  redness  was  observed  at  the  ijoculated  part  on  this  child’s  arm  for  two  or 
three  days  ;  but  this  had  wholly  disappeared  on  the  seventh  day,  when  she  was  inoculated  with  variolous 
matter,  which  produced  the  disease  in  a  favorable  manner. 


SIXTY-FOURTH  CASE. 

John  Jenkins  became  indisposed  on  the  twelfth  day,  and  was  very  restless  for  three  days.  He  had 
about  300  pustules. 

SIXTY-SIXTH  CASE. 

Henry  Barber  had  a  slight  fever  on  the  eighth  day,  when  symptoms  of  dentition  supervened,  hut  the 
fever  was  of  short  duration.  He  had  but  one  pustule  and  that  was  upon  his  upper  lip. 

SIXTY-FIFTH  CASE. 

Thomas  Dix’s  arm  exhibited  an  extensive  efflorescence  on  theelveenth  day,  and  some  evanescent  pustules 
appeared  ;  but  he  never  manifested  any  indisposition  during  the  progress  of  the  infection  . 

SIXTY-SEVENTH  CASE. 

Ann  Walker  became  indisposed  on  the  ninth  day,  and  continued  fretful  about  twenty-four  or  thirty 
hours;  the  fever  then  ceaSed,  and  she  has  since  been  wholly  free  from  disorder.  No  eruption  appeared. 

SIXTY-EIGHTH  CASE. 

Samuel  Francis  Brough  was  taken  ill  on  the  ninth  with  spasmodic  paroxysms,  succeeded  by  fever ;  the 
former  were  of  short  duration,  but  the  latter,  with  occasional  intermissions,  continued  for  three  days. 
Eleventh  day — Some  pastules  appeared  ;  their  number,  however,  when  the  eruption  was  completed,  did  not 
exceed  twenty. 

SIXTY-NINTH  CASE. 

Alexander  Bowser  was  restless  and  feverish  about  two  days.  Ten  pustules  appeared. 

SEVENTIETH  CASE. 

'William  Knighton  had  no  eruption .  He  was  a  little  indisposed  between  the  seventh  and  tenth  days  . 

SEVENTY-FIRST  CASE. 

Sarah  Price  had  some  indisposition  on  the  ninth  d-iy.  which  terminated  in  a  diarrhoea.  On  the  thirteenth 
day  she  was  perfectly  well  :  two  pustules  were  now  discovered  upon  her  right  foot,  which  were  all  she  had  • 

SEVENTY-SECOND  CASE. 

Elizabeth  Spisbury  was  somewhat  indisposed  on  the  tenth,  and  on  the  fifteenth  day  ;  but  the  latter  indis- 
osition  was  the  effect  of  teething.  She  had  no  eruption. 

SEVENTY-THIRD  CA$E. 

Elizabeth  May  was  a  little  feverish  on  the  eighth  day,  and  continued  somewhat  restless  till  the  thirteenth 
pay ;  five  pustules  appeared. 

SEVENTY-FOURTH  CASE. 

Mary  Ann  Sully  was  feverish  on  the  ninth  day,  and  passed  a  restless  night,  but  on  the  next  morning  she 
was  better  ;  she  made  no  further  complaint,  and  no  pustules  appeared. 

SEVENTY-FIFTH  CASE. 

Francis  Terry,  became  feverish  on  the  ninth  day  ;  the  next  morning  a  rash  appeared,  when  he  seemed  Po 
lie  as  well  as  usual.  He  had  only  one  pustule. 

SEVENTY-SIXTH  CASE. 

William  Scott  was  a  little  feverish  on  the  eighth  day  only  ;  no  eruption  ensued. 


10G 


Cow-Pox ;  William  Woodville ,  ilf.  J). 


SEVENTY-SEVENTH  CASE. 

William  Johnson’s  arm  tumified  in  the  usual  manner.  lie  had  no  pustules,  nor  did  he  appear  feverish  dur¬ 
ing  the  course  of  the  disease  ;  but  on  the  evening  of  the  thirteenth  day.  he  was  thought  to  be  a  little  rest¬ 
less. 

SEVENTY-EIGHTH  CASE. 

Mary  Stewart,  like  Johnson,  was  not  perceptibly  indisposed  during  the  whole  progress  of  the  infection 
neither  had  she  any  pustules. 

The  above  patients  inoculated  with  the  matter  taken  from  Streeton,  were  subsequently  inoculated  for  the 
small-pox,  without  affecting  anv  but.  Charlotte  Mile,  in  whom  the  inoculation  for  cow-pox  took  no  effect. 

February  27th,  Joseph  Wrench,  24  years  old ;  Stephen  Peters,  IK  years  old;  Peter  Peters,  18  years  old; 
Elizabeth  Brown,  5  years  old  ;  Mary  Shipley,  3  years  old  ;  Margaret  Crosby,  10  months  old,  and  John  Evans, 
7  months  old.  were  inoculated  with  the  matter  of  cow-pox,  taken  from  the  arm  of  James  Smith. 

SEVENTY-NINTH  CASE. 


Joseph  Wrench  continued  indisposed  from  the  tenth  till  the  thirteenth  day.  An  efflorescence  appeared 
at  the  inoculated  part  on  the  eleventh  day.  Fifteenth  day — Several  pustules  appeared,  and  he  now  com¬ 
plained  of  a  sore  throat,  which  continued  three  days.  The  number  of  pustules  was  thirty, 

EIGHTIETH  CASE. 

Stephen  Peters  began  to  complain  on  the  eighth  day,  and  continued  tojbe  affected  with  the  usual  febrile 
symptoms  till  the  thirteenth  day.  He  had  only  one  pustule. 

EIGHTY-FIRST  CASE. 

Peter  Peters’  complaints  were  similar  to  those  in  the  preceding  case.  The  efflorescence  did  not  appear, 
till  the  eleventh  day.  He  had  twenty-four  pustules,  all  of  which  were  very  small. 

EIGHTY-SECOND  CASE. 


Elizabeth  Brown’s  tumor  on  the  eighth  day  was  surrounded  by  an  efflorescence, 
nor  had  she  any  eruption. 


EIGHTY-THIRD  CASE. 


She  made  no  complaint. 


Mary  Shipley’s  arm  exhibited  an  efflorescence  on  the  eighth  day;  but  was  not  perceptibly  indisposed,  and 
had  only  one  pustule. 

EIGHTY-FOURTH  CASE. 

Margaret  Crosby  had  no  eruption,  nor  was  she  perceptibly  ill  during  the  progress  of  her  inoculation.  Her 
arm,  however,  tumified  in  the  usual  manner,  and  displayed  an  efflorescence. 

EIGHTY-FIFTH  CASE. 


On  John  Evan’s  arm  there  was  an  efflorescence  on  the  sixth  day,  and  the  following  day  a  slight  fever 
commenced  with  a  spasmodic  paroxysm,  but  he  was  perfectly  well  on  the  ninth,  and  no  eruption  took  place. 

The  above  five  persons  have  been  since  inoculated  with  variolous  matter  without  effect. 

Sarah  Hat,  twenty  years  old;  and  Elizabetli  Platford,  seventeen  years  ©Id,  were  inoculated  with  matter 
of  the  cow-pox  taken  from  the  arm  of  Maria  Murrell . 

EIGHTY-SIXTH  CASE. 

Sarah  Hat  began  to  complain  on  the  sixth  day,  and  she  continued  much  indisposed  till  the  eleventh 
day,  when  the  tumor  was  surrounded  by  an  efflorescence,  and  she  made  no  further  complaint.  The  num¬ 
ber  of  the  pustules  which  appeared  was  about  forty. 

EIGHTY- SEVENTH  CASE. 

Elizabeth  Platford  was  taken  ill  on  the  ninth  day,  when  she  complained  of  pain  in  the  head  and  loins, 
with  chilliness,  etc.;  the  inoculated  part  at  this  time  was  considerably  inflamed;  the  tumor  was  circular, 
but  flat,  and  not  surrounded  by  any  efflorescence.  Eleventh  day. — The  pains  and  shiverings  continuo; 
pulse  very  frequent  and  weak;  tongue  white.  Thirteenth  day.— The  symptoms  still  continue;  she  also 
complains  of  pain  across  the  shoulders?  some  pustules  appear.  Fifteenth  day. — She  complains  of  pain  in 
the  loins  and  of  giddiness;  the  number  of  the  pustules  is  much  increased.  Seventeenth  day . — The  pains 
continue;  she  is  very  weak  and  faint;  her  eyes  and  throat  are  inflamed  and  painful;  the  edges  of  the  tumor 
are  beset  with  confluent  pustules  ;  the  pustules  upon  her  face  are  about  200  or  300,  and  approach  to  conflu- 
ency .  Kineteenth  day. — Her  face  is  considerably  swelled,  and  the  pustules  are  now  maturating  rapidly  ; 
she  makes  no  complaint,  but  of  the  soreness  occasioned  by  the  eruption.  Twenty-first  day. — Swelling  of 
the  face  much  subsided  ;  the  pustules  in  a  state  of  desication  Twenty-third  day — She  continues  recover¬ 
ing.  Twenty-sixth  day. — She  complains  of  a  sore  throat,  and  a  cough  is  troublesome  to  her  Twenty- 
eighth  day.- — The  sore  throat  is  almost  gone,  hut  the  cough  continues  ;  pulse  100.  Thirtieth  day.— The 
cough  is  still  violent.  Thirty-second  day . — The  cough  is  abated,  and  her  appetite  improves;  from  this 
time  she  gradually  recovered. 

,  Both  the  above  patients  were  afterwards  inoculated  with  variolous  matter,  which  produced  no  effect. 

Isaac  Cowling,  twenty-three  years  old ;  Mary  Webb,  twelve  years  old;  Sophia  Mason,  two  years  and  a 
half  old;  and  Elizabeth  Goodluck,  three  months  old,  were,  on  the  2d  of  March,  inoculated  for  the  cow-pox 
with  matter  from  the  arm  of  G.  Keed. 

EIGHTY-EIGHTH  CASE. 

Isaac  Cowling  sickened  on  the  ninth,  and  the  eruptive  complaints  did  not  wholly  go  off  till  the  fourteenth 
day.  He  had  about  fifty  pustules. 


Cow-Pox ;  William  Woodville ,  M.  I). 


107 


'  EIGHTY-NINTH  CASE. 

Mary  W ebb  began  to  complain  on  the  seventh  day,  and  continued  feverish  for  a  week.  On  the  tenth  day 
a  redness  was  diffused  over  the  greatest  part  of  her  arm,  between  the  elbow  and  shoulder,  and  did  not 
wholly  disappear  till  the  fourteenth  day.  She  had  about  twelve  pustules. 

NINETIETH  CASE. 

Sophia  Mason's  arm  tumihed  in  the  usual  way,  and  exhibited  an  efflorescence  on  the  tenth  day.  She  had 
four  or  five  small  evanescent  pustules,  but  did  not  seem  indisposed  during  the  course  of  the  infection. 

NINETY-FIRST  CASE. 

”  Elizabeth  Goodluck  was  taken  ill  on  the  eighth  day,  when  she  had  a  slight  spasmodic  tit ;  the  tumor  at  this 
time  exhibited  an  efflorescence.  Eleventh  day — Has  had  no  indisposition  since  yesterday.  No  eruption 
took  place. 

None  of  the  above  three  patients  took  the  small-pox  in  consequence  of  inoculation  with  variolous  matter. 

NINETY-SECOND  AND  NINETY-THIRD  CASES. 

March  3. — C  S.  Cooke,  four  years  old;  and  A.  T.  Cooke,  two  years  old  ;  were  inoculated  with  the  matter 
of  cow-pox,  taken  from  the  arm  of  George  Meacock. 

An  efflorescence  at  the  inoculated  part  took  place  in  both  these  children  on  the  tenth  day,  but  neither  of 
them  seemed  indisposed  from  the  inoculation,  nor  did  any  pustules  appear  upon  them.  They  were  also  put 
to  the  test  of  inoculation  with  variolous  matter,  but  no  disease  ensued. 

March  3. — A.  K.  Gunter,  one  year  old  ;  Matthew  Sears,  nine  months  old;  and  Eliz.  Giles,  nine  months 
old,  were  inoculated  with  the  matter  of  cow-pox,  taken  from  the  arm  of  H.  Dobiuson. 

NINETY-FOURTH  CASE. 

A.  K.  Guuter  was  a  little  feverish  for  two  days.  On  the  tenth  day  the  tumor  was  surrounded  by  an 
efflorescence,  which  became  very  extensive.  Only  two  or  three  imperfect  pustules  appeared. 

NINETY-FIFTH  CASE. 


Matthew  Sears  was  indisposed  for  about  four  or  five  days.  The  tumor  was  small  and  angular,  nor  was 
it  ever  surrounded  with  an  efflorescence.  He  had  about  200  pustules. 

NINETY-SIXTH  CASE. 


Elizabeth  Giles  became  indisposed  on  the  tenth  day.  The  tumor  had  a  dark  red  colored  border  without 
any  efflorescence.  She  had  from  70  to  100  pustules. 

The  above  patients  have  been  inoculated  with  variolous  matter  without  effect. 

Richard  Scott,  two  years  and  a  half  old;  Sarah  Bennett,  one  year  old;  Maria  Black,  one  year  old  ;  Mary 
Jenkins,  nine  months  old  ;  John  Lawyer,  eight  months  old  ;  Eliz  King,  six  months  old  ;  William  Jones,  six 
months  old  ;  Esther  Phipps,  six  mouths  old ;  and  Ann  Harper,  five  mouths  old,  were  inoculated  with  the 
matter  of  cow-pox,  taken  from  the  arm  of  Elizabeth  Brown. 

NINETY-SEVENTH  CASE. 

Richard  Scott  became  feverish  for  a  short  time  on  the  tenth  day.  He  had  about  fourteen  pustules. 

NINETY-EIGHTH  CASE. 

Elizabeth  King’s  tumor,  on  the  ninth  day,  was  surrounded  with  an  efflorescence.  She  did  not  manifest 
any  indisposition,  nor  had  any  eruption. 


NINETY-NINTH,  ONE  HUNDREDTH  AND  ONE  HUNDRED  AND  FIRST  CASES. 

The  cases  sf  John  Lawyer,  William  Jones  and  Sarah  Bennett  were  similar  to  that  of  King. 


ONE  HUNDRED  AND  SECOND  CASE. 

Esther  Phipps  wasa  little  restless  and  feverish  from  the  tenth  till  the  thirteenth  day,  but  had  no  eruption. 

ONE  HUNDRED  AND  THIRD  CASE. 

Maria  Black  became  feverish  on  the  ninth  day,  and  was  indisposed  for  two  or  three  days,  during  which 
time  she  had  two  slight  convulsions.  Some  pustules  appeared,  but  did  not  suppurate. 

ONE  HUNDRED  AND  FOURTH  CASE. 

Mary  Jenkins  was  a  little  indisposed  on  the  tenth  day.  She  had  no  eruption 

ONE  HUNDRED  ^XD  FIFTH  CASE. 

Ann  Harper  was  a  little  restless  during  the  seventh  and  eighth  night,  but  no  eruption  took  placo. 

ONE  HUNDRED  AND  SIXTH  CASE. 


Thhmas  Newman  was  feverish  from  the  seventh  till  the  twelfth  day ;  bat  no  pustules  appeared 

March  4th,  Geor  ge  Paul,  3 years  old  ;  Ann  Paul,  1  year  old  ;  Martha  Chandler,  5  months  old  ;  Martha  Hat, 
1  year  old  ;  Eliz.  Board  ore,  7  months  old  ;  Samuel  Lampart,  2  years  old  ;  Ann  Page,  one  year  and  a  halt  olcl ; 
Jane  Carter,  5  weeks  old  ;  William  New,  18  months  old  ;  Susan  Sermon,  C  months  old  ;  Alice  Marshall,  2 
years  old  ;  Harriat  Marshall.  4  months  old.  and  Frances  Henley,  5  years  old,  were  inoculated  with  the  mat¬ 
ter  of  cOw-pox,  taken  from  the  arm  of  Elizabeth  May. 


108 


Cow  Pox  :  William  Woodville ,  M.  1). 


ONE  HUNDRED  AND  SEVENTH  CASE. 

George  Paul  Vas  not  perceptibly  indisposed  from  the  inoculation.  He  bad  two  pustules. 

ONE  HUNDRED  AND  EIGHTH  CASE. 

Ann  Paul  was  feverish  for  about  three  days,  and  had  forty  pustules,  all  of  which  were  much  smaller  than 
those  of  the  small-pox - 

ONE  HUNDRED  AND  NINTH  CASE. 

Martha  Chandler’s  inoculation  produced  a  very  extensive  efflorescence;  but  neither  fever  nor  eruption 
ensued. 

ONE  HUNDRED  AND  TENTH  CASE. 

Martha  Hat  did  not  become  indisposed  till  the  thirteenth  day,  when  a  few  small  pustules  appeared. 

ONE  HUNDRED  AND  ELEVENTH  CASE. 

Elizabeth  Boardore’s  arm  tumified  considerably;  but  neither  efflorescence,  fever,  nor  eruption,  took  place. 

ONE  HUNDRED  AND  TWELFTH  CASE. 


Samuel  Lampart  was  somewhat  disordered  from  the  ninth  till  the  twelfth  day.  and  had  three  small  imper¬ 
fect  pustules. 

ONE  HUNDRED  AND  THIRTEETH  CASE. 


'Ann  Page  wa9  not  sensibly  indisposed  from  the  inoculation,  neither  had  she  any  eruption.  The  tumor 
was  surrounded  with  an  efflorescence  on  the  twelfth  day. 

ONE  HUNDRED  AND  FOURTEENTH  CASE. 

Jane  Carter  was  slightly  indisposed  from  the  seventh  till  the  tenth  day,  and  had  two  or  three  pustules 

ONE  HUNDRED  AND  FIFTEENTH  CASE. 

William  New  was  ill  four  days,  and  had  about  100  pustules. 

ONE  HUNDRED  AND  SIXTEETH  CASE. 

Susan  Sermon  was  taken  ill  on  the  ninth  day,  when  she  vomited.  She  continued  feverish  till  the  twelfth  • 
day.  Only  five  pustules  appeared. 

ONE  HUNDRED  AND  SEVENTEENTH,  ONE  HUNDRED  AND  EIGHTEENTH  AND 

ONE  HUNDRED  AND  NINETEETH  CASES. 

Alice  Marshall,  Prances  Henley,  and  Hauiet  Marshall  had  no  eruption,  nor  appealed  to  have  any  disorder 
from  the  inoculation.  The  local  disease,  however,  was  considerable  in  all  these  patients,  and  was  attended 
with  an  efflorescence. 

All  the  above  patients  who  received  the  infection  from  Brown  and  May,  have  since  been  inoculated  for 
the  small-pox  without  effect. 

ONE  HUNDRED  AND  TWENTIETH  CASE. 

Mary  Crouch,  aged  three  years,  was  inoculated  with  matter  taken  from  one  of  the  pustules  upon  John 
Turner  (see  case  forty-sixth) .  A  tumor  formed  at  the  inoculated  part  in  the  usual  manner,  which  was  sur¬ 
rounded  with  an  efflorescence;  but  neither  fever  nor  eruption  took  place. 


ONE  HUNDRED  AND  TWENTY-FIRST  AND  ONE  HUNDRED  TWENTY-SECOND 

CASES. 

Elizabeth  Wood,  aged  three  years,  and  Win.  Clifford,  two  years  and  a  half  old.  were  inoculated  with  cow- 
pox  matter,  taken  from  the  arm  of  Mary  Stewart,  March  4th.  Both  those  children  were  slightly  indisposed 
about  the  tenth  day,  but  neither  of  them  had  any  pustules. 

March  6  — The  following  persons  were  inoculated  with  the  matter  of  cow-pox,  taken  from  the  arm  of 
Ann  Walker : 

Amelia  Kestieux,  4  months  old  ;  John  Bates,  6  weeksold ;  Martha  Thompson,  2years  old  ;  William  London, 
6  months  old  ;  Fi  ances  Wallace.  3  years  old  ;  Joseph  Rogers,  42  years  old  ;  Thomas  Thoroughgood,  14  years 
old;  and  Ann  Thoroughgood,  17  years  old. 

ONE  HUNDRED  AND  TWENTY-THIRD  AND  ONE  HUNDRED  AND  TWENTY- 

FOURTH  CASES. 

Amelia.  Restieux  and  John  Bates  neither  experienced  any  disorder  from  the  inoculation,  nor  had  any 
eruption  ;  but  both  their  arms  tumified  in  the  usual  manner. 

ONE  HUNDRED  AND  TWENTY-FIFTH  CASE. 

Martha  Thompson  was  feverish  from  the  eight  till  the  tenth  day.  She  had  only  one  pustule. 

ONE  HUNDRED  AND  TWENTY-SIXTH  CASE. 

William  London  was  taken  ill  on  the  tenth  day  ;  aud  vomited  ;  but  the  following  day  was  as  well  as  usual. 
He  had  no  eruption .  . 

ONE  HUNDRED  AND  TWENTY-SEVENTH  CASE. 

James  London  had  no  perceptible  disorder ;  and  no  pustules  appeared.  On  the  tenth  day  the  tumor  was 
surrounded  with  an  efflorescence. 

ONE  HUNDRED  AND  TWENTY-EIGHTH  CASE. 

Frances  Wallace  was  feverish  for  two  or  threo  days,  but  no  eruption  ensued. 


Cow  Pox  :  William  Woodville ,  M.  1). 


109 


ONE  HUNDERD  AND  TWENTY-NINTH  CASE. 

Joseph  Rogers  on  the  eighth  day  complained  of  pain  in  the  axilla,  and  was  affected  with  headache  for  two 
or  three  days  ;  but  he  had  no  eruption. 

ONE  HUNDRED  AND  THIRTIETH  CASE. 

Thomas  Thoroughgood  made  the  same  complaints  as  Rogers.  He  had  thirty-three  pustules. 

ONE  HUNDRED  AND  THIRTY-FIRST  CASE. 

Ann  Thoroughgood  was  indisposed  for  six  or  Seven  days,  but  she  had  only  ten  pustules. 

The  preceding  twelve  patients  have  had  variolous  matter  inserted  in  their  arm  without  effect. 

The  following  persons  were  inoculated  with  the  matter  taken  from  the  pustules  of  Martha  Streeton,  viz  : 
Susan  Reeve,  18  months  old;  Ann  Reeve,  5  weeks  old ;  Susan  Richardson,  13  years  old,  and  Mary  Adams, 
6  months  old. 

ONE  HUNDRED  AND  THIRTY-SECOND  AND  ONE  HUNDRED  AND  THIRTY- 

THIRD  CASES. 

Susan  Reeve  and  Ann  Reeve  were  very  little  disordered  by  the  inoculation  ;  the  former,  however,  had, 
twenty  and  the  latter  twelve  pustules. 

ONE  HUNDRED  AND  THIRTY-FOURTH  CASE. 

Susan  Richardson  continued  indisposed  from  the  tenth  till  the  fourteenth  day,  but  she  had  only  twelve 
pustules. 

ONE  HUNDRED  AND  THIRTY-FIFTH  CASE. 

Mary  Adams  had  about  two  hundred  pustules  ;  hut  the  eruptive  symptoms  were  not  severe.  The  (u  nor 
in  this  case  spread,  and  formed  an  irregular  margin,  which  was  studded  with  confluent  pustules. 

March  7. — The  disease  was  transferred  from  the  pustules  upon  Sarah  Dixon  to  the  following  children,  viz: 
Caroline  Harriskind,  4  years  old  ;  Wm.  Harrisltind,  2  years  old;  Daniel  Harding,  14  weeks  old;  Eliza¬ 
beth  Harding,  3  years  old ;  James  Waters,  12  years  old,  and  Joseph  Harding,  17  .years  old. 

ONE  HUNDRED  AND  THIRTY-SIXTH  AND  ONE  HUNDRED  AND  THIRTY- 

SEVENTH  CASES. 

Caroline  and  Wm.  Harriskind  were  feverish  for  two  or  three  days.  The  former  had  100,  and  the  latter 
had  twelve  pustules. 

OND  HUNDRED  AND  THIRTY-E1  HTII  AND  ONE  HUNDRED  AND  THIRTY- 

NINTH  CASES. 

Daniel  and  Elizabeth  Harding  were  but  very  slightly  indisposed  from  the  inoculation.  Daniel  had  fifteen 
very  small  pustules;  Elizabeth  had  only  two. 

ONE  HUNDRED  AND  FORTIETH  CASE. 

James  Waters  complained  of  headache,  pains  of  his  limbs  and  sore  throat,  from  the  eighth  till  the  four' 
teenth  day.  The  tumor  at  the  inoculated  part  was  never  much  elevated  above  the  skin,  and  had  an  angu- 
lated  border.  He  had  120  pustules. 

ONE  HUNDRED  AND  FORTY-FIRST  CASE. 

Joseph  Harding  was  very  slightly  disordered,  and  had  no  pustules . 

March  8  — William  Shipton.  4  years  old  ;  George  Staits,  2  years  old  ;  Elizabeth  Youngman,  3  months  old  : 
Mary  Dudley,  2  years  old  ;  William  Cade,  10  months  old,  and  William  Piper,  4  months  old,  were  inoculated 
with  the  matter  of  cow-pox,  taken  from  the  arm  of  Esther  Phipps. 

ONE  HUNDRED  AND  FORTY-SECOND,  ONE  HUNDRED  AND  FORTY-THIRD, 
ONE  HUNDRED  AND  FORTY-FOURTH  AND  ONE  HUNDRED  AND  FORTY- 
FIFTH  CASES. 

William  Shipton,  Elizabeth  Youngman,  William  Cade  and  William  Piper,  had  no  pustules  ;  and  none  ot 
them  appeared  to  be  disordered  from  the  inoculation,  except  Piper,  who  was  a  little  feverish  on  the  eighth 
day.  *  An  efflorescence  took  place  around  the  tumor  in  all  of  them. 

ONE  HUNDRED  AND  FORTY-SIXTH  CASE. 

George  Staits  was  indisposed  lor  two  days,  and  had  three  or  four  small  pustular  eruptions. 

ONE  HUNDRED  AND  FORTY-SEVENTH  CASE. 

Mary  Dudley  was  a  little  feverish  on  the  ninth  dav,  when  a  rash  appeared  which  receded  the  following 
day,  and  about  fifty  small  pustules  were  discovered  ;  these,  however,  disappeared  in  the  course  ot  twenty- 
four  hours. 

March  11.- — Hannah  Timms,  lD^years  old  ;  Susan  Timms,  17  years  old  ;  Jane  Franklin,  12  years  old,  and 
Henry  tee,  15  years  old,  were  inoculated  with  the  matter  of  cow-pox,  taken  from  the  arm  of  Mary  Webb. 

ONE  HUNDRED  AND  FORTY-EIGHTH  CASE. 

Hannah  Timms  was  affected  with  the  febrile  symptoms  from  the  eighth  till  the  sixtei  nth  day  and  had  (65 
pustules,  all  of  which  suppurated. 

ONE  HUNDRED  AND  FORTY-NINTH  CASE. 

Sarah  Timms  was  ill  from  the  ninth  till  the  fourteenth  day.  She  had  no  eruption. 


110 


Cow  Pox  :  William  Woodville ,  M.  D. 


ONE  HUNDRED  AND  FIFTIETH  CASE. 

Jane  Franklin  was  very  little  indisposed  from  the  inoculation,  and  had  no  eruption. 

ONE  HUNDRED  AND  FIFTY-FIRST  CASE. 

Henry  Lee  complained  for  two  or  three  days,  and  had  only  one  pustule. 

March  13 — The  following  persons  were  inoculated  with  the  matter  of  cow-pox,  taken  from  the  arm  of 
Sarah  Hat,  viz.:  Ann  Spooner,  twenty-one  years  old  ;  Matthew  Wall,  fourteen  years  old;  John  Wall,  ten 
years  old;  William  Ockendon,  twelve  years  old;  Joseph  Ockendon,  ten  years  old  ;  Willirm  Jennings,  seven 
years  old  ;  George  Jennings,  six  years  old:  John  Pluokrose,  seven  years  old;  Charlstte  Webb,  fourteen 
weeks  old  ;  Charles  Dibdon,  three  months  old;  Elizabeth  Eaton,  two  years  gld ;  Charlotte  Eaton, ten  months 
old  ;  and  Joseph  Pigg,  eleven  3  ears  old. 

ONE  HUNDRED  AND  FIFTY-SECOND  CASE. 

Ann  Spooner  was  indisposed  for  three  or  four  days  and  had  150  pustules. 

ONE  HUNDRED  AND  FIFTY-THIRD  CASE. 

Matthew  Wall  was  a  little  indisposed  for  three  days.  He  had  ten  pustules. 

ONE  HUNDRED  AND  FIFTY-FOURTH  CASE. 

John  Wall  made  no  complaint,  and  had  no  eruption. 

ONE  HUNDRED  AND  FIFTY-FIFTH  CASE. 

William  Ockendon  was  indisposed  from  the  eighth  till  the  tenth  day.  He  had  only  one  pustule. 

ONE  HUNDRED  AND  FIFTY-SIXTH  CASE. 

Joseph  Ockendon  was  ill  for  three  days.  He  had  no  eruption. 

[ONE  HUNDRED  AND  FIFTY-SEVENTH  CASE. 

William  Jennings  complained  of  headache  two  days.  He  had  only  one  pustule. 

ONE  HUNDRED  AND  FIFTY-EIGHTH  CASE. 

George  Jenniugs  was  disordered  in  the  same  manner  as  his  brother  William,  but  he  had  no  eruption. 

ONE  HUNDRED  AND  FIFTY-NINTH  CASE. 

John  Pluekrose  made  no  complaint  and  had  no  eruption. 

ONE  HUNDRED  AND  SIXTIETH  AND  ONE  HUNDRED  SIXTY-FIRST  CASES. 

Charlotte  Webb  and  Charles  Dibden. — The  former  was  perceptibly  disordered  by  the  inoculation,  and  had 
no  pustules.  The  latter  was  a  little  feverish  on  the  ninth  day  and  vomited.  He  had  three  pustules  at  the 
inoculated  part  only. 

ONE  HUNDRED  AND  SIXTY-SECOND  AND  ONE  HUNDRED  AND  SIXTY-THIRD 

CASES. 

Elizabeth  Eaton  and  Charles  Eaton  were  both  slightly  indisposed  oh  the  eleventh  and  twelfth  day,  and 
each  had  about  twenty  pustules. 

ONE  HUNDRED  AND  SIXTY-FOURTH  CASE. 

Joseph  Pigg  complained  of  a  pain  in  the  axilla,  and  of  a  slight  headache  for  four  days.  He  had  fourteen 
pustules  only.  , 

March  13. — The  following  were  inoculated  with  the  matter  of  cow-pox,  taken  from  the  arm  of  Samuel 
Lamport,  viz.-.  Mary  Ockendon,  sixteen  years  old  :  Sarah  Ockendon,  seven  years  old  ;  Sarah  Stacey,  twelve 
years  old  :  Ann  Stacey,  seven  years  old  ;  Mary  Fuller,  eleven  years  old  ;  Isabella  Barrett,  eleven  years  old  ; 
Mary  Perry,  three  years  old  ;  Susan  Vinirnm,  five  months  old  ;  Elizabeth  Kensden,  eighteen  months  old  ; 
Mary  Ward,  ten  months  old;  William  Terry,  two  months  old;  Caroline  Poorey,  three  years  old;  Ann 
Poorey,  eleven  months  old ;  John  Langstaff,  four  years  and  a  half  old ;  Emma  Lightfoot,  thirteen  mouths 
old;  Daniel  Sinclair,  seven  months  old  ;  M.  H.  Hills,  eighteen  weeks  old;  and  Catharine  Donaldson,  nine¬ 
teen  months  old, 

ONE  HUNDRED  AND  SIXTY-FIFTH  CASE. 

Mary  Ockendon  was  indisposed  from  the  ninth  till  the  fourteenth  day.  She  bad  only  six  pustules. 

ONE  HUNDRED  AND  SIXTY-SIXTH  CASE. 

Sarah  Ockendon  complained  of  headache,  pain  of  her  limbs,  etc.,  from  the  tenth  till  the  fourteenth  day; 
but  only  four  pustules  appeared. 

ONE  HUNDRED  AND  SIXTY-SEYENTH  CASE. 

Sarah  Stacey  was  indisposed  from  the  tenth  till  the  fifteenth  day.  No  pustules  appeared. 

ONE  HUNDRED  AND  SIIXTY-EIGHTH  CASE. 

Ann  Stacey’s  case  was  similar  to  that  of  her  sister  Sarah. 

ONE  HUNDRED  AND  SIXTY-NINTH  AND  ONE  HUNDRED  AND  SEVENTIETH  CASES. 

Mart-  Fuller  and  Isabella  Barrett,  both  complained  of  the  febrile  syrnpftuns  from  the  ninth  till  the  four¬ 
teenth  day.  The  former  had  six,  and  the  latter  twenty  pustules. 

ONE  HUNDRED  AND  SEVENTY- FIRST,  ONE  HUNDRED  AND  SEVENTY-SECOND  AND  ONE 

HUNDRED  AND  SEYENTY-THIRI)  CASES. 

Mary  Perry,  Susan  Vinicum  and  Elizabeth  Bronsden  did  not  appear  to  be  indisposed  from  the  inocula 
tion,  and  hail  no  eruption  ;  but  the  tumors  in  all  were  considerable,  and  surrounded  by  an  efflorescence. 

ONE  HUNDRED  AND  SEVENTY-FOURTH  CASE. 

Mary  Ward  was  a  little  feverish  for  two  days,  and  a  few  small  pustules  appeared  for  one  day  only. 


Ill 


Cow  Pox :  William  Woodville ,  M.  D. 

ONE  HUNDRED  AND  SEVENTY-FIFTH,  ONE  HUNDRED  AND  SEVENTY-SIXTH,  ONE  HUN¬ 
DRED  AND  SEVENTY-SEVENTH  AND  ONE  HUNDRED  AND  SEVENTY-EIGHTH  CASES. 

William  Terry,  Ann  Poorey,  Caroline  Poorey  and  Join.  Langstaff  had  no  pustules,  neither  did  any  of  them 
appear  to  be  indisposed,  except  Ann  Poorey,  who  was  feverish  for  two  days. 

ONE  HUNDRED  AND  SEVENTY-NINTH  AND  ONE  HUNDRED  EIGHTIETH  CASES. 

Emma  Lightfoot  and  Daniel  Sinclair  were  both  a  little  disordered  for  two  or  three  days,  and  the  former 
had  four  or  live  small  pustules,  but  the  latter  had  no  eruption. 

ONE  HUNDRED  AND  EIGHTY-FIRST  AND  ONE  HUNDRED  AND  EIGHTY-SECOND  CASES, 

Ann  Hills  and  Catharine  Donaldson  had  neither  fever  nor  eruption, 

ONE  HUNDRED  AND  EIGHTY-THIRD  CASE. 

Ann  Clarke  was  inoculated  with  the  matter  of  cow-pox,  taken  from  the  arm  of  Peter  Peters,  which  pro¬ 
duced  two  or  three  small  evanescent  pustules  ;  but  no  fever  took  place. 

March  15. — John  Buektkorpe,  twenty-two  years  old  ;  John  Cater,  fourteen  years  of  age  ;  Susan  Tomlins, 
nineteen  years  old ;  Maria  Burgess,  four  years  old  ;  and  Sophia  Burgess,  three  years  old,  were  inoculated  for 
the  cow-pox,  with  matter  taken  from  the  arm  of  Joseph  Wrench. 

ONE  HUNDRED  AND  EIGHTY-FOURTH  CASE, 

John  Buckthorpe  was  indisposed  Irom  the  ninth  till  the  fourteenth  day.  He  had  nearly  100  pustules, 

ONE  HUNDRED  AND  EIGHTY-FIFTH  CASE. 

John  Cater  complained  of  headache,  etc.,  from  the  eighth  till  the  eleventh  day.  He  had  forty  pustules. 

ONE  HUNDRED  AND  EIGHl'Y-SIXTH  CASE. 

Susan  Tomlins  continued  ill  for  three  days.  She  had  twenty -four  pustules. 

ONE  HUNDRED  AND  EIGHTY-SEVENTH  AND  ONE  HUNDRED  AND  EIGHTY-EIGHTH  CASES 

Maria  and  Sophia  Burgess  were  neither  indisposed  from  the  inoculation .  Sophia  had  no  pustules  and 
Maria  only  three. 

March  18  — The  following  persons  were  inoculated  with  the  matter  of  cow-pox,  taken  from  the  arm  of 
Elizabeth  PI  at  ford  :  John  Williams,  seven  mouths  old  ;  James  Huntsman,  three  months  old;  Robert  Lear 
seventeen  months  old  ;  John  S.elb.y,  live  mouths  old;  Samuel  Ariell,  two  years  old  ;  James  Ariel!,  live  years 
old;  Henry  Servy,  two  years  and  a  half  old;  Sarah  Lovell,  four  years  old;  Henry  Lovell,  two  years  old; 
Rebecca  Salmon,  nine  months  old;  John  Corwell,  eight  months  old,  and  Francis  Cundell,  six  months  old. 

ONE  HUNDRED  AND  EIGHTY-NINTH  CASE. 

John  Williams  had  no  indisposition  nor  pustules.  The  tumor  was  surrounded  with  an  efflorescence!)  j. 
the  eleventh  day. 

ONE  HUNDRED  AND  NINETIETH  CASE, 

James  Huntsman  was  a  little  feverish  on  the  evening  of  the  tenth.  He  had  no  eruption. 

ONE  HUNDRED  AND  NINETY-FIRST  CASE. 

Robert  Lear’s  case  was  similar  to  that  of  Huntsman. 

ONE  HUNDRED  AND  NINETY-SECOND  CASE. 

John  Selby  was  feverish  two  days,  and  had  forty  pustules. 

ONE  HUNDRED  AND  NINETY-THIRD  AND  ONE  HUNDRED  AND  NINETY-FOURTH  CASES 

Samuel  Ariell  and  James  Ariell  were  both  feverish  on  the  tenth  and  eleventh  days,  but  neither  had  any 
eruption, 

ONE  HUNDRED  AND  NINETY-FIFTH  AND  ONE  HUNDRED  AND  NINETY-SIXTH  CASES. 

Henry  Servy  and  Sarah  Lovell  were  disordered  two  days.  The  former  had  no  pustules,  the  latter  forty 
ONE  HUNDRED  AND  NINETY-SEVENTH  CASE 

Henry  Lorell  was  ill  three  days,  and  had  170  pustules. 

ONE  HUNDRED  AND  NINETY-EIGHTH  CASE. 

Rebecca  Salmon  was  very  slightly  indisposed,  but  had  about  200  pustules,  which  were  very  small. 

ONE  HUNDRED  AND  NINETY-NINTH  AND  TWO  HUNDREDTH  CASES. 

John  Corwell  and  Francis  Cundell  were  both  feverish  for  two  or  three  days;  the  former  had  thirty 
six  and  the  latter  twelve  pustules. 

All  the  above  patients,  inoculated  since  the  0th  of  March,  have  subsequently  had  variolous  matter  in¬ 
serted  in  their  aims,  except  the  two  Ariells,  but  it  produced  no  disorder. 


Iii  order  that  the  progressive  descent  of  the  cow-pox  infection  from  patient  to  patient, 
as  well  as  the  magnitude  of  the  disease  which  was  excited  by  the  inoculation,  may  be 
comprehended  at  one  view,  I  have  subjoined  the  following  tabular  statement. 

It  may  be  observed  that  the  matter  used  for  the  preceding  inoculations  was  not  only 
derived  immediately  from  the  pustular  eruptions  upon  the  teats  ofthecow,  but  also  from 
Sarah  Rice,  who  contracted  the  disease  by  mi. king  the  infected  cows.  I  begin  with  the 
former.  In  the  first  and  second  divisions  opposite  to  the  names  the  age  in  years  or 
mouths  is  recorded;  in  the  third  the  number  of  days  during  which  the  febrile  symptoms 
continued  ;  and  in  the  last,  the  number  of  pustules  produced  : 


112 


Cow  Pox:  William  Woodvtlle,  M.  I). 


TABLE. 


x  © 

h  b  J. 

Months. 

-  x 

-*-l  X 
O  <p 
x  3 

C3M 

P 

.  x 

il 

p 

o 

X  © 

H  bt 

(SH 

|  Mouths. 

Days  of 

Illness. 

P-l  X 

Q  ® 

•  *3 

11 

Pi 

From  the  cow  to — 

From  Webb  to— 

M.  Payne . 

2 

G 

3 

0 

17 

fj 

n 

4 

5 

o 

12 

1 

o 

4 

4 

24 

1  ee  ..  . 

15 

2 

3 

R.  Payne  . 

10 

0 

5 

From  Halt  to— 

10 

1 

4 

21 

4 

110 

17 

a 

170 

Jl M.  Wall  . 

14 

3 

10 

15 

0 

0 

J  Wall  . 

10 

0 

0 

From  M.  and  E.  Payne  to — 

J.  Ockendon . 

10 

.  . 

3 

0 

11 

12 

J 

1 

15 

o 

1 

From  Collingride  to — 

G.  Jennings . 

6 

2 

0 

O 

7 

0 

o 

25 

0 

530 

C.  Webb  . . 

3 

0 

0 

13 

2 

(i 

3 

1 

0 

19 

1 

0 

E .  Eaton . . 

2 

9 

2 

10 

2 

2 

13 

2 

6 

11 

4 

14 

From  Redding  to — 

From  Plat  ford  to— 4 

^\Tife  . 

11 

0 

4 

0 

0 

From  Muudy  to — 

Huntsman  . 

.  . 

3 

1 

0 

21 

4 

1 

5 

1 

0 

From  George  to — 

Selby . 

5 

2 

40 

Tarrant . 

19 

,  , 

1 

0 

S.  Ariell  . 

2 

.  . 

2 

0 

From  Butcher  to — 

J.  Ariell  . 

5 

,  . 

2 

0 

20 

o 

0 

Servy  . . 

2 

G 

o 

0 

20 

6 

310 

S.  Lovell . 

4 

2 

40 

West 

21 

5 

20 

H.  Lovell  . 

2 

3 

170 

W  Hull 

1  1 

4 

200 

9 

1 

200 

H.  Hull . . 

13 

.. 

1 

8 

Corwell  . 

8 

3 

36 

$  Hull  . 

8 

2 

120 

Cui  id  ell . .  ...... 

6 

2 

12 

From  Jewel  to — 

From  S.  Rice  to — 

4 

4 

40 

Harris . 

21 

0 

300 

15 

5 

70 

Bunker  . 

15 

3 

3 

From  S.  Price  to — 

Crouch . . 

7 

0 

0 

11 

5 

40 

Fox  .  . 

5 

5 

102 

23 

Hickland . 

6 

3 

300 

From  Crouch  to— 

9 

7 

200 

Keys  . 

25 

1 

0 

From  Fisk  to — 

Turner  . 

24 

6 

220 

3 

1 

3 

Morgan  . ; . 

1 

5 

0 

Murrell . 

7 

4 

20 

From  Mr.  Coleman’s  cow  to — 

From  Bumpus  to — 

Streeton  . . 

22 

.  . 

6 

300 

19 

4 

174 

Smith . . . 

16 

4 

105 

W.  Walker . . 

11 

0 

0 

Meacock . 

30 

.  . 

5 

350 

Cummins  . 

3 

0 

0 

From  Turner  to — 

3 

2 

0 

Fairbrother . 

15 

4 

4 

8 

3 

0 

Calloway . . . 

19 

3 

20 

From  West  to — 

Camplin . 

17 

4 

30 

5 

0 

0 

J.  Tin  ner . . 

.  8 

2 

1000 

3 

0 

0 

Buckley . 

5 

1 

0 

1 

] 

0 

Welch  * . 

3 

1 

0 

Giles  . 

20 

30 

30 

From  Streeton  to — 

From  W est  to — 

Grenvill  . 

20 

3 

35 

18 

5 

12 

Honey  wood . . . 

2 

0 

1) 

16 

4 

2 

Rood. .......  . . . 

1 

6 

2 

0 

From  Reed  to — 

Mile . 

1 

3 

0 

0 

23 

4 

50 

1 

3 

300 

Webb 

12 

0 

12 

Barber . 

11 

2 

1 

O 

6 

0 

4 

Dix  . 

11 

0 

0 

3 

2 

0 

A.  Walker . 

10 

2 

0 

From  M  urrell  to — 

Brough . . 

10 

3 

20 

20 

4 

40 

8 

2 

10 

P  bit  ford 

17 

8 

1000 

Rnighton . 

8 

2 

0 

From  H .  Dobinson  to — 

Price  . 

8 

i 

0 

1 

0 

3 

Spilsbury. . 

4 

2 

0 

9 

5 

200 

May . 

4 

4 

5 

9 

3 

90 

Sully . 

3 

1 

0 

From  Dixon’s  pustule  to— 

Terry . . . 

2 

1 

1 

4 

4 

100 

Scott  . 

2 

1 

0 

2 

3 

12 

J  ohuston  . . 

2 

0 

0 

3 

1 

15 

Stewart  . . . 

2 

0 

0 

E,  Harding . 

3 

1 

2 

From  Smith  to — 

12 

6 

] 

20 

W  rench . . . 

24 

3 

30 

l~i 

1 

10 

S.  Peters  . 

19 

4 

1 

From  Webb  to— 

P.  Peters . 

18 

.  . 

4 

24 

H.  Timms .  . 

19 

7 

1C5 

Brown . 

5 

.  • 

0 

0 

Cow-Pox:  William  Wooclville ,  M.  D 


113 


From  Smith  to — 

Shipley . 

Crosby . . 

Evans . 

From  Me  acock  to — 

C .  Cooke . . . 

A.  Cooke . 

From  Brown  to — 

R.  Scott . . . . 

Bennett . 

Black  . 

M.  Jenkins . 

Lawyer . 

From  Brown  to — 

King . . 

Jones  . 

Phipps . 

Newman  . 

Harper . 

From  May  to — 

G.  Paul . 

A.  Paul . • . 

Chandler . 

M.  Hatt . 

Board  ore . 

Lampart. . . 

Page  . 

Carter . 

Sermon . 

A.  Marshall . 

H.  Marshall . 

Henley . 

New . . 

From  Turner’s  pustules  to — 

M.  Crouch . 

From  Stewart  to— 

Wood . 

Clifford. . . 

From  A.  Walker  to — 

Restieux . 

Bates  . 

Thompson . 

W.  London . 

J.  London . 


Years  of 

Age . 

outh  8 

Days  of 

Illness 

No.  of 
Pustules 

Years  of 

Age. 

GO 

q 

o 

a 

Days  of 

Illnes 

No.  of 
P  u stules 

From  A.  Walker  to — 

— 

3 

•  • 

0 

1 

W  allaee . 

3 

2 

o 

,  . 

10 

0 

0 

Rogers  .  . 

42 

3 

0 

i 

2 

0 

T.  Thorougligood . 

14 

3 

33 

A.  Thorougligood . 

17 

6 

10 

4 

•* 

0 

0 

From  Streeton’s  pustules  to — 

2 

•  • 

0 

0 

S.  Reeve . 

1 

6 

1 

20 

A.  Reeve . 

.  , 

1 

1 

12 

2 

6 

1 

14 

Richardson . . 

13 

3 

12 

1 

•  • 

0 

0 

Adams .  . 

6 

3 

200 

1 

•  • 

3 

7 

From  Phipps  to — 

.  . 

9 

1 

0 

Ship  ton . . 

4 

0 

0 

8 

0 

0 

Staits  . 

2 

2 

3 

Youngman . 

3 

0 

0 

.. 

6 

0 

0 

Dudley . 

2 

1 

50 

0 

0 

0 

Cade . 

.  . 

10 

0 

0 

6 

3 

0 

Piper . 

.  . 

4 

1 

0 

.  . 

6 

4 

0 

From  Lampart  to— 

5 

2 

0 

10 

4 

S.  Ockendon . 

17 

3 

4 

3 

•  • 

0 

2 

S.  Stacey . . 

12 

4 

0 

1 

3 

40 

A.  Stacey . 

7 

4 

0 

.  . 

5 

0 

0 

Fuller . . 

ii 

4 

0 

1 

. . 

1 

5 

Barrett . 

ii 

4 

20 

7 

0 

0 

Perry . 

3 

0 

0 

2 

2 

3 

Yinicum . 

4 

5 

0 

0 

1 

6 

0 

0 

Bensden . 

i 

6 

0 

0 

1 

2 

3 

Ward  . 

10 

2 

7 

.  . 

0 

3 

5 

Terry . . . 

. . 

2 

0 

0 

2 

0 

0 

C.  Poorey . 

3 

0 

0 

4 

(1 

0 

A.  Poore v . 

.  . 

11 

2 

0 

5 

.  . 

0 

0 

Langstaff . 

4 

6 

0 

0 

1 

6 

4 

100 

Lightfoot . 

1 

1 

2 

5 

Sinclair . 

7 

2 

0 

3 

.  . 

0 

0 

Hills  . 

4 

0 

0 

Donaldson . 

1 

7 

0 

0 

3 

.  . 

1 

0 

From  W rench  to — 

2 

6 

1 

0 

Bucktkorpe .  . 

22 

4 

100 

Cater . 

14 

2 

40 

. , 

4 

0 

0 

Tomlin . 

19 

3 

24 

0 

0 

0 

M.  Burgess  . 

4 

0 

3 

2 

1 

2 

S.  Burgess . 

3 

0 

0 

.  , 

d 

0 

0 

From  P .  Peters  to  — 

| 

6 

0 

0 

Clarke  .  —  . . 

.  . 

f 

3 

The  preceding  table  comprehends  all  the  cases  originally  intended  to  have  been  given 
in  the  work,  the  publication  of  which,  from  a  concurrence  of  circumstances,  has  been 
delayed  much  longer  than  the  author  expected,  and  has  thereby  afforded  him  an  oppor¬ 
tunity  of  making  the  following  additions  : 


' 

Years  of 
Age. 

02 

-*-1 

fl 

o 

3 

Days  of 
Illness. 

.  ®  ■ 
■4-1  rt, 
Orp 

ll 

PH 

Years  of 
Age. 

Months. 

Days  of 
Illness . 

No.  of 
Pustules. 

From  Platford’s  pustues  to — 

From  A.  Stacey  to — 

i 

0 

30 

8 

1 

6 

i 

9 

0 

40 

10 

2 

50 

6 

1 

0 

3 

2 

20 

Palmer  . 

3 

3 

100 

From  M.  Ockendon  to — 

Henderson . . 

10 

4 

300 

22 

4 

100 

Crawford . . . 

i 

10 

3 

250 

Dach . . . 

44 

o 

0 

From  Dudley  to — 

G.  Pigley . 

, . 

5 

0 

0 

A.  Yale n tine . 

3 

2 

0 

24 

0 

0 

J-  Yalentine . 

2 

3 

0 

19 

6 

156 

From  S.  Timms  to 

Harrison . 

2 

i 

0 

S.  Harris  .  . 

21 

7 

6 

5 

0 

0 

S.  Clarke . 

9 

2 

o 

4 

11 

0 

0 

M.  Harris . 

23 

6 

60 

4 

1 

0 

Ludgrove . 

11 

2 

o 

3 

3 

0 

0 

Stringer . 

20 

4 

2 

M  Hide  . 

4 

11 

0 

0 

From  Grenville  to — 

D .  Hide . 

1 

5 

0 

0 

B .  C  ran  e .  . 

2 

3 

200 

8 

o.  0 

T.  Crane . 

4 

2 

12 

From  Tomlin  to — 

Garrett  . 

14 

4 

62 

3 

1 

0 

M,  Crane.... . . . 

8 

4 

30 

1 

0 

0 

From  A.  Stacey  to — 

Oliphant . 

3 

1 

0 

38 

3 

5 

6 

1 

0 

R.  Stacey . i . . 

7 

0 

12 

2 

0 

0 

J.  Stacey . 

3 

6 

0 

5 

A.  Smith . 

4 

’  c 

0 

114 


Cow  Pox:  Wiiliam  Woodville,  M.  I). 


© 

X  © 
2  tl 

Im 

|  Months. 

Days  of 

Illness. 

No.  of 

Pustules. 

Year 8  of] 

Aee. 

Months. 

Days  of 

Illness. 

No.  of 
Pustules- 

From  Tomlin  to — 

From  Wade  to — 

4 

C 

c 

Mays . 

] 

1 

2 

500 

From  J.  Wall  to — 

From  J.  Mundy  to — 

: 

] 

C 

Matthews . 

4 

2 

0 

Barneby . 

i 

e 

0 

0 

From  Brewster  to — 

2 

E 

( 

2 

M.  Brewster . 

11 

( 

0 

Dalkins . 

54 

1 

0 

From  Lee’s  pustules  to — 

] 

2 

2 

2 

Baker .  . 

2S 

: 

140 

( 

2 

0 

Caterer . 

15 

0 

5 

8 

From  J.  Yallentine  to — 

R.  Featherstone . 

12 

3 

40 

a 

0 

0 

C.  Feathers  ton  pi . 

9 

j 

120 

4 

3 

5 

Porter  . 

5 

0 

9 

Gedge  . 

k 

0 

0 

From  Lee’s  pustules  to — 

3 

t 

4 

J.  Porter  . 

1 

6 

1 

12 

1 

10 

2 

40 

J.  Jennings . 

5 

i 

30 

From  Spooner  to — 

C.  Jennings . 

3 

#  m 

1 

30 

16 

a 

34 

W.  Jennings . r _ 

1 

1 

0 

9 

4 

0 

0 

Mansfield . 

1 

6 

2 

12 

10 

3 

6 

S.  Wybfow . 

6 

2 

300 

2 

0 

0 

S.  Baker . 

1 

1 

3 

25 

19 

4 

35 

J.  Goss . 

2 

8 

1 

0 

6 

4 

12 

W .  Goss . 

8 

2 

30 

4 

0 

6 

Odell  . 

9 

3 

90 

1 

fe 

3 

6 

Murphield . 

6 

2 

0 

Freeman  . . 

11 

4 

40 

From  Dalkins  to — 

9 

2 

40 

Sharp . . . . 

n  • 

4 

0 

0 

Wade. .  . 

16 

4 

3 

From  W aite  to — 

From  Cooper  to — 

T.  Jennings . 

1 

6 

0 

0 

1 

50 

Ivitchen  . . 

5 

1 

0 

From  H.  Timm’s  pustules  to — 

S.  Pluckrose . 

4 

.. 

2 

0 

Stiles  . 

6 

3 

500 

T.  Pluckrose  . 

10 

2 

0 

5 

i 

12 

Rout  . 

6 

1 

20 

From  M.  Bartlett  to — 

W .  Houghton  . 

2 

6 

1 

0 

J.  Mundy  . 

6 

3 

100 

From  Swannell  to— 

From  Cowley  to — 

Mickland . 

• . 

2 

0 

3 

Nash  . . . . 

15 

1 

0 

Ferguson .  . 

t  _ 

7 

1 

7 

From  Spooner’s  pustules  to— 

Goddard . . 

1 

2 

0 

Serjeant . 

16 

4 

35 

Robfits  . 

. . 

9 

1 

0 

Cook  ...  .  . 

15 

2 

11 

Gran  . 

6 

1 

0 

From  Stringer’s  pustules  to — 

Benson . 

• . 

8 

2 

0 

Argant  .  . 

17 

7 

19 

FI  oak s  . 

2 

1 

2 

From  It.  Timm’s  pustules  to — 

From  M.  Gilbert  to — 

17 

3 

4 

AVelch . 

15 

3 

100 

Brewster . 

11 

4 

6 

Rowley . 

3 

2 

25 

Trulock . 

6 

2 

250 

A .  W aite . .  ... 

17 

4 

10 

A\  iggins . 

5 

0 

7 

Tarbotts . . . 

1 

1 

2 

600 

Th  ."turner . 

6 

0 

50 

S.  Tarbotts .  . 

3 

3 

4 

300 

Gilbert . . . 

6 

3 

500 

Bell  . 

3 

3 

250 

Downes . 

4 

2 

30 

From  S.  Hopes  to — 

Kinc . 

2 

2 

4 

Snell  . 

17 

2 

200 

Talbot . 

4 

3 

500 

I.  Honyhton . 

32 

3 

200 

From  Corwell  to— 

Stedmanl . 

•  . 

6 

2 

60 

Graham . . 

4 

0 

0 

6 

2 

200 

Sellers . 

15 

0 

0 

Sorrell . 

4 

11 

4 

500 

From  Barrett  to — 

S.  Sorrell  . 

6 

1 

1 

T.  Barrett . 

32 

3 

200i 

Underwood  . 

.  . 

9 

2 

105 

M.  Barrett . 

5 

0 

0 

From  Ellikin  to — 

J.  Barrett . 

*  2 

3 

1 

0 

G.  Cooke . . . . . 

2 

2 

3 

20 

H.  Barrett . 

7 

2 

30 

Costin . 

5 

2 

0 

E.  Wybrow . 

'5 

3 

200 

From  Reynolds  to — 

T.  Wybrow . 

9 

3 

150 

Walford . . . 

.  . 

6 

2 

600 

J.  Wybrow . 

1 

1 

6 

From  Wade  to — 

Harwood  . 

2 

3 

1 

6 

Wen  worth . 

1 

8 

3 

500 

M.  Harwood . 

4 

0 

12 

8 

0 

0 

J.  Harwood . . 

5 

2 

6 

Lister  . 

5 

0 

0 

p .  Harwood  . 

5 

4 

200 

W  ooden . 

i 

4 

4 

0 

Hicsins . 

3 

0 

0 

Smart . . . 

6 

2 

0 

M.  Higgins . . . 

2 

6 

0 

5 

Taylor . 

1 

1 

200 

From  Henderson  to — 

Arnold . 

5 

3 

0 

TJpstone  . 

19 

5 

12 

Turvey . 

3 

2 

12 

I.  Bumpus . 

If) 

5 

20 

Guilder . 

2 

3 

2 

0 

From  S .  Harris  to — 

Gallap . 

2 

2 

0 

Tyler  . 

13 

0 

0 

Stanny . . 

2 

2 

4 

2 

Meacock  . 

18 

5 

400 

4 

0 

0 

It.  Meacock . 

1 

3 

6 

2 

6 

1 

0 

M.  Meacock . 

29 

5 

20 

From  Oliphant  to — 

Porch . 

3 

6 

0 

2 

7 

1 

0 

E.  Porch . 

2 

0 

0 

From  M .  Ford  to — 

J.  Porch . 

4 

3 

350 

Clark . 

2 

4 

3 

0 

Fermoy . 

11 

0 

60 

Cox . . . 

1 

7 

2 

0 

Gurney . 

11 

0 

0 

2 

u 

0 

Downs . 

1 

6 

2 

300 

¥ 


Cow-Pox  :  William  Woodville,  M.  I).  115 

—  -  - * — - * 


0 

V  £ 
-  bj 

£  ^ 

1 

Months. 

a. 

T  j- 

i  H 

a 

"t!  £ 

6 

A  s 

Ph 

0 

■n 

-  b l 

'M 

Months. 

O  GC 
a 

Si 

No.  of 
Pustules  . 

From  J.  Roberta  to — 

From  Kitchen  to — 

— 

T.  Roberts . 

3 

3 

0 

16 

] 

From  Kitchen  to — 

Raymond . 

i 

1 

3 

3 

T.  Foster . 

5 

2 

5 

From  I.  Harwood  to — 

J.  Foster . . . 

1 

1 

2 

26 

4 

100 

M.  Foster . 

1 

1 

24 

1 

4 

S.  Gobby . 

27 

2 

20 

4 

6 

5 

500 

50 

W.  Gobby . 

5 

0 

2 

5 

6 

2 

J.  Gobby . 

6 

3 

0 

2 

6 

1 

25 

Putney . 

7 

2 

0 

g 

4 

5 

Bush  . 

1 

7 

1 

0 

6 

3 

700 

E.  Franklin . 

3 

2 

0 

3 

3 

600 

S.  Franklin . 

1 

0 

0 

From  Talbot  to — 

350 

Neat . 

2 

2 

9 

6 

3 

_ 

Hicks . . 

3 

o 

0 

9 

4 

60 

More . 

5 

0 

0 

1 

3 

2 

oDU 

100 

Barker  . 

6 

2 

6 

3 

4 

North  . 

2 

3 

0 

.  l 

2 

4 

oO 

Cowland . 

1 

3 

3 

12 

9 

4 

700 

Harrison . 

8 

1 

5 

10 

4 

4oU 

R.  Lawyer . 

36 

1 

1 

8 

3 

17 

E.  Lawyer . 

3 

V) 

1 

7 

5 

4 

7d 

F.  Lawyer . 

4 

6 

0 

0 

3 

6 

3 

ID 

M.  Lawyer . 

1 

0 

0 

8 

3 

14 

E .  Dunn . 

5 

0 

0 

6 

2 

DUU 

F.  Lhinn . 

2 

6 

0 

0 

i 

7 

3 

2UU 

T.  Bunn . 

3 

o 

0 

From  J.  Goss  to — 

IdU 

N.  Collop . 

9 

1 

0 

o 

0 

J.  Collop . 

7 

1 

0 

7 

0 

A.  Collop . 

3 

1 

0 

Haywood . 

i 

8 

4 

46 

E .  Collop . . . . 

5 

0 

o 

1 

2 

T.  Wicgins . 

7 

0 

0 

3 

3 

W.  Wiggins .  . 

4 

0 

0 

6 

0 

P .  Wiggins . 

1 

6 

0 

0 

3 

3 

50 

19 

2 

6 

2 

0 

Bridges . 

1 

.  0 

0 

6 

4 

From  J. "Barrett  to — 

I.  Mountain . 

4 

6 

2 

300 

I.  Mitchell  . 

6 

2 

200 

2 

2 

P.  Mitchell  . 

2 

2 

50 

A  .  Mountain . . . 

1 

1 

75 

T.  Mitchell . 

2 

2 

26 

From  Brewster  to — 

From  Cook  to — 

Barnett . 

1 

1 

0 

0 

E-  Chapman . 

12 

2 

27 

Balling . . . 

9 

2 

6 

M .  Chapman . . . 

9 

3 

67 

1 

9 

3 

q 

Good . 

13 

4 

400 

1 

1 

2 

6 

From  Styles  to — 

Hilliard . 

6 

0 

0 

Edwards  . . . 

18 

3 

0 

1 

4 

1 

0 

From  Talbot  to — 

From  W.  Meacock  to — 

Brandrom  . . . 

12 

0 

0 

Westbrook . 

3 

0 

0 

From  Caterer  to — 

From  E.  Chapman  to — 

22 

4 

300 

2 

1 

o 

17 

4 

43 

1 

8 

3 

12 

Waller  . 

18 

3 

15 

5 

2 

4 

Wall .  t . . 

8 

3 

200 

From  M  Chapman  to — 

3 

2 

0 

18 

0 

3 

30 

6 

3 

500 

16 

3 

12 

From  Bradley’s  pustules  to — 

Ledger . 

4 

2 

50 

5 

2] 

12 

1 

1 

2 

Vethall . 

4 

3 

200 

McKennisli . 

4 

3 

2 

150 

Hope . 

6 

4 

100 

Wright . . 

7 

3 

10 

5 

2 

20 

2 

0 

0 

Green . 

2 

4 

3 

30 

From  Ruffles  to — 

Lutman . . 

1 

2 

20 

Thornton . 

17 

1 

0 

Roberts . 

3 

4 

50 

16 

2 

3 

Starbuck . 

5 

2 

20 

H  ill . 

5 

1 

0 

M.  Phillips . 

0 

2 

3 

500 

1 

3 

1 

0 

S.  Phillips . 

3 

1 1 

3 

5 

11 

0 

0 

Wicks . 

4 

3 

36 

8 

0 

0 

Terrv . 

3 

2 

g 

4 

1 

0 

Sheriff . 

7 

3 

34 

9 

0 

0 

Steers . 

13 

3 

40 

5 

0 

0 

From  I.  Houghton  to— 

From  A.  Waite  to — 

S.  fi  ought  on . 

19 

o 

o 

22 

4 

6 

W.  Houghton . 

58 

o 

d 

16 

2 

0 

Jolly . 

i 

g 

0 

0 

12 

2 

0 

From  T.  Piuckrose  to — 

M.  Bartlett . . 

ii 

1 

20 

19 

3 

3 

3 

0 

15 

W  oodlard .  .  . 

2 

0 

0 

Clark . 

•  • 

9 

0 

0 

116 


Cow-Pox:  William  Woodville,  M.  1). 


Those  wlio  are  acquainted  with  the  history  of  the  cow-pox,  will,  no  doubt,  be  surprised 
to  find  from  the  preceding  cases  that  pustules  have  frequently  been  the  consequence  of 
the  inoculation  of  this  disease.  Indeed,  when  I  first  observed  a  pustular  eruption  upon 
Buckland,  (Case  3d)  the  occurrence  being  wholly  unexpected,  I  was  not  without  appre¬ 
hension  that  the  lancet  which  was  employed  in  its  inoculation  might  have  had  some  par¬ 
ticles  of  variolous  matter  adhering  to  it.  But  this  suspicion  was  soon  removed,  for, 
upon  enquiry,  I  found  that  all  the  lancets  which  I  had  used  on  the  twenty-first  of  Janu¬ 
ary  were  then  made  use  of  for  the  first  time  since  they  had  been  ground  by  the  cutler. 

Among  the  patients  inoculated  for  the  cow-pox  during  the  first  week  in  which  I  ob¬ 
tained  the  matter  of  this  disease,  several  were  so  circumstanced  as  to  be  afterwards  con¬ 
stantly  exposed  to  the  infection  of  the  cow-pox.  Having  then  had  no  proof  that  the 
progress  of  the  infection  of  the  former  would  supersede  that  of  the  .latter,  I  used  the  pre¬ 
caution  to  inoculate  the  patients  with  variolous  matter  on  the  fifth  day  after  that  taken 
from  the  cow  had  been  inserted.  This  led  some  medical  gentlemen  to  suppose  that  the 
matter  locally  formed  in  the  arm  from  the  first  inoculation  might  be  variolated  by  the 
progress  of  the  second  inoculation  in  the  other  arm,  and  that  consequently  the  matter 
generated  in  the  cow-pox  tumor  with  which  others  were  inoculated  would  produce  a  hy¬ 
brid  disease  and  not  the  genuine  small-pox.  But  as  the  matter  employed  in  the  cow-pox 
inoculations  was  always  taken  before  the  constitution  could  be  effected  by  the  variolous 
matter,  and  during  the  time  that  both  inoculations  were  merely  local  diseases,  I  appre¬ 
hend  its  effects  would  be  the  same  as  if  the  variolous  inoculation  had  not  taken  place. 
Nay,  had  this  not  been  the  case,  but  had  several  patients  been  inoculated  with  matter 
taken  from  the  cow-pox  tumor  on  the  arm  of  Jane  Colliugridge,  after  both  the  inocula¬ 
tions  were  supposed  to  have  affected  the  constitution  for  several  days,  neither  facts  nor 
analogy  lead  us  to  believe  that  the  matter  thus  obtained  would  produce  any  other  disease 
than  that  of  its  own  species,  or  that  its  specific  morbid  quality  would  be  changed  by  en¬ 
tering  info  combination  with  the  virus  of  the  small-pox.  The  general  character  of  the 
tumor  formed  by  the  inoculation  of  the  small  pox  is  very  different  from  that  of  the  cow- 
pox ;  and  though  on  the  same  day  a  person  be  inoculated  in  one  arm  with  the  matter  of 
the  cow-pox,  and  in  the  other  with  that  of  the  small-pox,  yet  both  tumors  preserve  their 
respective  characteristic  appearances  throughout  the  whole  course  of  the  disease.  This 
is  certainly  a  strong  proof  that  the  two  diseases,  in  respect  to  their  local  action,  continue 
separate  and  distinct. 

Twenty-eight  patients  were  on  the  same  day  inoculated  with  the  matter  of  cow-pox 
and  that  of  the  small-pox,  mixed  together  in  equal  quantities,  in  order  to  try  which 
would  prevail,  or  if  it  were  possible  to  produce  a  hybrid  disease  by  a  union  ol  both. 
The  result  was  that  in  more  than  one-half  of  the  patients  thus  inoculated,  the  local  affec¬ 
tion  distinctly  assumed  the  characters  of  the  cow-pox  ;  in  the  others  it  more  resembled 
the  small-pox,  but  in  none  of  them  was  there  much  indisposition  or  many  pustules. 

At  the  request  of  Dr.  Jenner,  I  transmitted  to  him,  in  Gloucestershire,  some  of  the 
cow-pox  matter  from  the  patients  then  under  my  care,  which  he  used  for  the  purpose  of 
inoculation  ;  affer  a  trial  of  it  he  informed  me  that  “the  rise,  progress  and  termination 
of  the  pustule  created  by  this  virus  on  the  arm,  was  exactly  that  of  the  true  unconi  ani¬ 
mated  cow-pox.”  The  matter  sent  was  taken  from  the  arm  of  Ann  Bumpus,  who  had 
310  pustules,  all  of  which  suppurated;  yet  with  the  matter  of  this  stock  Dr.  Jenner  in¬ 
oculated  twenty,  and  another  gentleman,  in  the  same  county,  140  persons,  without  pro¬ 
ducing  any  pustules  w  hich  maturated. 

This  fact  would  appear  to  confirm  an  opinion  entertained  by  Dr.  Jenner.  In  bis  second 
publication  on  the  variola*,  vaccime  he  seems  disposed  to  attribute  the  pusti  les  which  so 
often  attended  this  disease  in  London  and  its  vicinity,  to  some  peculiar  influence  of  the 
town  air.  But  of  the  cases  which  I  have  stated,  several  were  those  of  patients  who  were 
inoculated  eight  miles  distance  from  London  ;  yet  these  patients,  in  the  proportion  of 
about  one  in  five,  had  an  eruption.  And  at  a  small  village,  still  farther  from  London, 
eighteen  persons  were  inoculated  with  similar  matter,  in  all  of  wdiom  it  produced  pus¬ 
tules. 

The  Twenty- seventh  case  also  affords  decisive  evidence  that  the  matter  employed  in  it 
vras  that  of  the  cowr-pox,  for  Jewel  had  undergone  the  small-pox  when  a  child  ;  yet  the 
inoculation  excited  febrile  symptoms  of  two  or  three  day’s  duration,  and  the  tumor  which 
was  produced  upon  her  arm  did  not  begin  to  scab  till  the  thirteenth  day. 

Having  now,  I  presume,  given  sufficient  reasons  for  establishing  the  point  for  which 
they  have  been  adduced,  I  shall  proceed  to  enquire  how  far  the  effects  of  the  cow-pox 
upon  the  human  subject  seem  to  differ  from  or  correspond  with  those  of  the  small-pox 
when  communicated  by  inoculation. 

The  vaccine  disease,  as  it  has  lately  been  called,  affords  a  striking  example,  and  per¬ 
haps  the  only  one  yet  discovered,  of  a  disorder  which  can  be  transferred  from  brute  ani¬ 
mals  to  man,  and  carried  back  from  him  to  the  brute.  A  remarkable  instance  of  this  is 
related  at  page  62,  wrhich  shows  that  the  matter  of  the  cow-pox,  as  reproduced  by  inoc¬ 
ulation  in  the  human  animal  and  inserted  into  the  teat  of  a  covr,  produced  the  disease. 


117 


Coiv-Pox  :  William  Woodville ,  M.  I). 


Similar  attempts  were  also  made  with  variolous  matter,  which  had  no  effect;  hence,  in 
this  respect  these  two  morbid  poisons  seem  to  differ.  'Die  cow-pox  also  differs  from  the 
small-pox  in  acting  upon  the  constitutions  ot  those  who  have  undergone  the  latter  dis¬ 
ease,  as  was  fully  exemplified  in  the  case  of  Frances  Jewel.  However,  I  am  disposed  to 
think  that  the  matter  of  the  cow-pox  is  not  so  capable  of  affecting  persons  who  have  had 
the  small-pox  as  has  been  represented.  I  made  several  trials  to  inoculate  this  disease  in 
patients  at  the  hospital  who  were  recovering  from  a  full  eruption  of  the  naiural  small¬ 
pox,  but  in  no  instance  did  any  tumor  appear  on  the  arm  ;  neither  does  the  insertion  of 
the  variolous  matter,  in  such  cases,  excite  the  least  inflammation  in  the  skin.  It  is  prob¬ 
able,  therefore,  that  the  matter  of  the  cow-pox,  like  that  of  the  small-pox,  does  not 
mauifest  any  local  action  upon  persons  who  have  lately  undergone  the  variolous  disease. 
It  a  person  has  casually  received  the  infection  of  the  small-pox,  and  be  inoculated  with 
vario  ous  matter  three  or  four  days  before  the  eruptive  symptoms  supervene,  the  inocu¬ 
lated  part  does  not  tumify,  as  in  other  cases,  but  becomes  a  simple  pustule  ;  on  the  con¬ 
trary,  if  a  person  has  been  inoculated,  and  the  progress  of  the  inoculation  be  so  far  ad¬ 
vanced  that  the  patient  is  within  one  day  of  the  approach  of  the  eruptive  fever,  and  be 
then  inoculated  a  second  time,  the  tumor  produced  from  the  second  inoculation  will  be¬ 
come  nearly  as  extensixe  as  the  first,  and  be  in  a  state  of  suppuration  a  few  hours  after 
the  fever  commences.  Hence  it  appears  that  the  process  of  variolation  in  the  natural 
and  in  the  inoculated  small-pox  is  different.  The  cow-pox,  in  every  case  with  which  we 
are  acquainted,  has  been  introduced  into  the  human  constitution  through  the  medium  of 
external  local  inflammation,  and  is  therefore  to  be  considered  as  an  inoculated  disease  ; 
the  virus  of  it  seems  also  to  affect  a  similar  mode  of  action,  and  to  be  governed  by  the 
same  laws  as  that  of  the  small-pox.  Thus  if  a  person  be  alternately  inoculated  with  va¬ 
riolous  matter  and  with  that  of  the  cow-pox  every  day  till  fever  is  excited,  all  the  inoc¬ 
ulations  make  a  progress  ;  and  as  soon  as  the  whole  system  becomes  disordered,  they  ap¬ 
pear  to  be  all  equally  advanced  in  maturation.  However,  the  local  tumor  excited  from 
the  inoculation  of  the  cow-pox  is  commonly  of  a  different  appearance  from  that  which  is 
the  consequence  of  inoculation  with  variolous  matter;  for  if  the  inoculation  be  per¬ 
formed  by  a  simple  puncture,  the  consequent  tumor,  in  the  proportion  of  three  times  out 
of  four,  or  more,  assumes  a  form  completely  circular,  and  it  continues  circumscribed, 
with  its  edges  elevated  and  well  defined,  and  its  surface  flat  throughout  every  stage  of 
the  disease;  while  that  which  is  produced  from  variolous  matter,  either  preserves  a  pus¬ 
tular  form  or  spreads  along  the  skin,  and  becomes  angulated  and  irregular,  or  disfigured 
by  numerous  vesiculae. 

Another  distinction,  still  more  general  and  decisive,  is  to  be  drawn  from  the  contents 
of  the  cow-pox  tumor;  for  the  fluid  it  forms,  unless  from  some  accidental  circumstance, 
very  rarely  becomes  puriform,  and  the  scab  which  succeeds  is  of  a  harder  texture,  exhib¬ 
its  a  smoother  surface,  and  differs  in  its  color  from  that  which  is  formed  by  the  concre¬ 
tion  of  pus.  All  the  appearances  here  described,  however,  do  not  constantly  attend  the 
disease,  but  are  some  times  so  much  changed  they  can  in  no  respect  be  distinguished 
from  those  which  arise  from  the  inoculation  of  the  small-pox.  When  the  disease  thus 
deviates  from  its  usual  appearance  at  the  inoculated  part,  its  effects  upon  the  constitu¬ 
tion  have  commonly,  though  not  always,  been  felt  more  severely  than  where  the  tumor 
was  distinctly  characterized. 

As  I  have  now  pointed  out  the  principal  circumstances  in  which  the  two  diseases 
usually  differ  in  their  local  effects,  I  shall  proceed  to  examine  them  in  a  more  important 
point  of  view,  and  to  compare  their  general  effect  upon  the  constitution,  in  order,  if 
possible,  to  ascertain,  from  the  facts  already  adduced,  whether  or  not  the  inoculation  of 
the  vaccine  disease  produces  a  milder  distemper,  and  of  less  dangerous  consequences  to 
the  patient,  than  that  of  the  small-pox.  For  if  it  be  an  established  fact,  as  I  presume 
it  is,  that  those  who  have  undergone  the  former  disease  are  thereby  rendered  secure 
against  the  effects  of  the  latter,  it  only  remains  to  be  proved,  in  order  to  make  the  former 
be  generally  adopted,  that  the  disorder  which  attends  the  cow-pox  is  also  less  severe  and 
less  fatal  than  the  other.  The  number  of  cases  of  cow-pox  inoculated  under  my  direc¬ 
tion  have  amounted  to  about  600,  but  all  these  could  not  be  included  in  the  table,  as  at 
the  time  it  was  printed  the  disease,  in  many  patients,  was  not  far  enough  advanced  to 
give  the  result ;  and  to  these  may  be  added  others  who  did  not  give  proper  attendance, 
anO  also  some  whose  names  I  am  not  permitted  to  make  public. 

The  table,  however,  contains  a  sufficient  number  of  cases  to  enable  the  medical  reader 
to  form  a  tolerably  correct  judgment  respecting  the  disease;  and  from  considering  what 
would  have  probably  been  the  effects  of  an  equal  number  of  cases  of  variolous  inocula¬ 
tion,  he  may  draw  his  own  conclusions.  But  before  this  is  done,  I  have  to  observe,  that 
since  the  table  war  composed,  an  infant  at  the  breast  died  on  the  eleventh  day  after  the 
cow-pox  matter  had  been  inserted  in  its  arm.  In  this  solitary  fatal  case,  the  local  tumor 
was  very  inconsiderable,  and  the  eruptive  symptoms  took  place  on  the  seventh  day, 
when  the  child  was  attacked  with  fits  of  the  spasmodic  kind,  which  recurred  at  short 
intervals  with  increased  violence,  and  carried  it  off  at  the  time  above  mentioned,  after 
an  eruption  of  eighty  or  one  hundred  pustules. 


118  Cow-Pox:  William  Woodville,  M.  D. 


It  appears,  therefore,  that  out  of  about  five  hundred  cases  of  the  inoculated  cow-pox 
one  proved  fatal,  and  the  preceding  table  shows  that  in  some  others  the  disease,  from  the 
number  of  the  pustules,  was  of  formidable  severity  ;  while,  on  the  other  hand,  a  very 
large  proportion  of  the  patients  were  scarcely  disordered  from  the  inoculation,  and  had 
no  nustnles. 

Were  I  enabled  to  state  a  number  of  cases  of  variolous  inoculation,  equal  to  those 
given  above,  and  reduced  to  a  similar  tabular  form,  the  comparative  magnitude  of  the 
two  diseases  might  be  estimated  with  tolerable  precision.  It  is  evident,  however,  that 
the  matter  of  the  vaccine  disease  has  generally  produced  much  fewer  pustules,  and  less 
indisposition  than  that  of  the  small-pox ;  for  it  appears  from  the  preceding  statement 
that  about  two-fifths  of  all  the  persons  inoculated  for  the  variolas  vaccinse,  had  no  pus¬ 
tules,  and  that  in  not  more  than  a  fourth  part  of  them  was  there  experienced  any  percepti¬ 
ble  disorders  of  the  constitution.  But  it  must  be  acknowledged,  that  in  several  in¬ 
stances.  the  cow-pox  has  proved  a  very  severe  disease.  In  three  or  four  cases,  out  of 
five  hundred,  the  patient  has  been  in  considerable  danger,  and  one  child,  as  I  have 
already  observed,  actually  died  under  the  effects  of  the  disease.  Now,  if  it  be  admitted 
that  at  an  average,  one  of  five  hundred  will  die  of  the  inoculated  cow-pox,  I  confess  I 
should  not  be  disposed  to  introduce  this  disease  into  the  Inoculation  Hospital,  because, 
out  of  the  last  five  thousand  cases  of  variolous  inoculation,  the  number  of  deaths  has 
not  exceeded  the  proportion  of  one  in  six  hundred.  But  I  am  inclined  to  think,  that  if 
the  matter  of  the  cow-pox,  used  for  the  purpose  of  inoculation,  were  only  taken  from 
those  in  whom  the  disease  appeared  in  a  very  mild  form,  the  result  would  be  more  favor¬ 
able  than  in  the  statement  here  given.  For  though  it  has  occasionally  happened,  that 
the  matter  taken  from  the  arm  of  a  patient,  in  whom  the  disorder  neither  produced  fever 
nor  eruption,  has  in  others  produced  both  ;  yet  still  it  has  much  more  commonly  had  the 
effect  of  exciting  a  milder  disease  than  the  matter  of  the  pustules,  or  than  that  which 
was  obtained  from  a  patient  who  had  the  disease  in  a  severe  manner,  as  may  be  seen  by 
and  examination  of  the  table. 

Thus  we  find,  that  out  of  sixtv-two  persons,  who  were  inoculated  wTitli  the  pustule 
matter,  fifty-seven  had  an  eruption  ;  and  those  who  received  the  disease  from  any  of 
these  fifty-seven  patients,  appear  also  to  have  had  pustules  in  nearly  the  same  proportion 
I  may  also  remark,  that  the  disease,  before  noticed  as  proving  fatal  to  a  patient,  was 
excited  from  matter  of  this  description,  and  taken  from  Talbot.  Whence  it 
appears,  that  the  cow-pox,  from  certain  circumstances,  is  not  only  liable  to  lose  the 
characters  which  distinguish  it  from  the  small-pox,  but  also  to  continue  to  propagate 
itself  under  this  new  and  casual  modification.  The  vaccine  variolse,  the  human  variola*, 
ought,  therefoi’e,  to  he  considered  as  only  varieties  of  the  same  disease,  rather  than  as 
distinct  species. 

One  important  advantage  which  the  cow-pox  is  supposed  to  have  over  the  small-pox  is 
that  the  former  is  not  a  contagious  disease,  and  not  to  be  propagated  by  the  effluvia  of 
persons  infected  with  it.  This  is  certainly  true  when  the  disorder  is  confined  to  the  in¬ 
oculated  part,  but  where  it  produces  numerous  pustules  upon  the  body,  the  exhalation 
they  send  forth  are  capable  of  infecting  others  in  the  same  manner  as  the  small-pox. 
Two  instances  of  casual  infection  in  this  way  have  lately  fallen  under  my  observation  ; 
in  one  the  disease  was  severe,  and  the  eruption  confluent;  in  the  other  the  disease  was 
mild,  and  the  pustules  few. 

It  has  been  asserted,  that  persons  have  had  the  small-pox  after  having  been  af¬ 
fected  with  the  cow-pox;  and  some  “facts  have1!  been  published  with  a  view  to 
show  that  instances  of  this  kind  have  actually  happened.  But  all  these,  as  far  as 
I  have  seen,  have  been  very  defective  in  not  affording  sufficient  proof,  that  the 
affection  supposed  to  have  been  the  cow-pox,  was  in  reality  that  disease.  On  the  other 
hand,  the  instances  which  have  been  brought  forward  to  prove  that  those  who  had  under¬ 
gone  the  genuine  cow-pox  resisted  the  infection  of  the  small-pox,  are  unquestionably 
decisive,  and  sufficiently  numerous  to  establish  the  fact  in  the  most  satisfactory  manner. 
This  cii-cumstance  then  appears  to  lie  as  much  a  general  law  of  the  system,  as  that  a 
person  having  had  the  small-pox  is  thereby  rendered  unsusceptible  of  l’eceiving  the  dis¬ 
ease  a  second  time.  For  of  all  the  patients  whom  I  inoculated  with  variolous  matter, 
after  they  had  passed  through  the  cow-pox,  amounting  to  upwards  of  four  hundred, 
none  were  affected  with  the  small-pox  ;  and  it  mav  be  remarked,  that  nearly  a  fourth 
part  of  this  number  was  so  slightly  affected  with  the  cow-pox,  that  it  neither  pi’oduced 
any  perceptible  indisposition  nor  pustules. 

We  have  been  told,  that  the  cow-pox  tumor  has  frequently  produced  erysipelatous 
inflammation,  and  phagedenic  ulceration;  but.  the  inoculated  part,  has  not  ulcerated  in  any 
of  the  cases  which  have  been  under  my  care,  norhave  T  observed  inflammation  to  occasion 
any  inconvenience,  except  in  one  instance,  where  it  was  soon  subdued  by  the  application 
of  aqua  lithargyri  acetati.  It  should  seem  then,  that  the  advantages  to  be  derived  from 
substituting  the  cow-pox  for  the  small-pox,  must  be  directly  in  proportion  to  the  greater 
mildness  of  the  former,  than  the  latter  disease. 

[End  of  Woodville  on  Cow-Pox.] 


THE  ERRORS  OF  DRS.  WOODVILLE  AND  PEARSON  AROSE 
FROM  THE  PERFORMANCE  OF  COW-POX  INOCULA¬ 
TION  IN  AN  ATMOSPHERE  POISONED  BY  THE 
CONTAGIOUS  EMANATIONS  OF  SMALL-POX. 


CORRECTION  OF  THE  ERRORS  OF  DR.  WOODVILLE  BY  DR. 

JENNER, 


EXPERIMENTS  OF  DR.  ROBERT  WILLAN  IN  THE  YEARS  1799 
AND  1800,  ON  THE  COMBINED  INOCULATION  OF  THE 
VARIOLOUS  AND  VACCINE  FLUIDS— REFERENCES  ILLUS¬ 
TRATING  THE  EXTENSIVE  NATURE  OF  THE  CONTRIBU¬ 
TIONS  BY  VARIOUS  OBSERVERS  TO  THE  LITERATURE  OF 
COW-POX  INOCULATION,  DURING  THE  FIRST  FIVE 
YEARS  AFTER  JENNER’S  ANNOUNCEMENT  OF  HIS  DISCOV¬ 
ERY. 


It  is  evident  from  the  preceding  reports  of  Dr.  Woodville,  that  he  en¬ 
deavored  to  establish,  that  the  substitution  of  vaccina  in  place  of  small¬ 
pox,  would  be  of  little  or  no  advantage  to  mankind,  as  it  was  in  many 
cases  attended  with  eruptions  not  inferior  in  severity  to  those  arising  from 
variolous  inoculation. 

The  error  into  which  the  gentleman  fell  with  regard  to  the  eruptions  be¬ 
ing  an  efitect  of  cow  pox  in  the  inoculated  form,  was  due  to  the  performance  of 
his  experiments  in  a  location  and  atmosphere  poisoned  by  the  emanations 
or  contagium  of  small-pox. 

Dr.  Woodville  performed  the  inoculation  from  whence  these  cases 
originated,  in  an  hospital  appropriated  to  variolous  inoculation.  In  such 
a  place  the  atmosphere  would  necessarily  have  been  surcharged  with  small¬ 
pox  infection,  and  the  building  with  every  article  of  furniture  of  such  an 
establishment,  must  have  been  loaded  with  variolous  effluvia ;  hence  the 
eruptions  are  easily  accounted  for,  as  a  person  is  susceptible  of  vaccine 
impression,  notwithstanding  he  may,  at  the  time  of  vaccination,  have  the 
infection  of  small-pox  in  his  system,  or  even  have  passed  through  that  dis¬ 
ease. 

Many  of  the  patients  experimented  on  by  Dr.  Woodville  at  the  small-pox 
hospital  in  London,  besides  being  exposed  to  variolous  atmosphere,  act¬ 
ually  had  small-pox  matter  inserted  into  the  arm  on  the  third  and  fifth 
days  after  vaccination. 


120 


Errors  of  Dr.  Woodville ,  exposed  by  Jenner  and  T Villan. 


Dr.  Jenner  had  positively  asserted  that  pustules  do  not  belong  to  the 
cow-pox,  as  he  had  never  seen  them  produced  by  genuine  vaccine  matter. 

Dr.  Woodville,  on  the  contrary,  reported  that  three-fiftlis  of  the  patients 
whom  he  had  inoculated  with  vaccine  matter  had  pustules  not  to  be  dis¬ 
tinguished  from  variolous  ones.  A  statement  of  this  kind, from  such  a  quar¬ 
ter,  so  much  at  variance  with  what  had  been  anticipated,  excited  the  strong¬ 
est  feelings  of  disappointment  among  the  principal  medical  men  of  Lon¬ 
don,  and  for  a  season  threw  considerable  doubt  on  Dr.  Jenner’s  accuracy. 

From  the  commencement  Dr.  Jenner  suspected  the  real  cause  of  this  de¬ 
viation  ;  but  he  was  willing  to  give  the  gentlemen  who  began  the  experi¬ 
ments  in  London  the  benefit  of  every  supposition  that  might  tend  to  ac¬ 
quit  them  of  the  blunder  which  they  had  actually  made.  He  thought  it 
possible  that  there  might  be  some  peculiarity  either  in  the  constitution  of 
the  individual  vaccinated,  or  something  in  the  nature  of  the  virus  itself 
that  might  occasion  the  eruptions;  but  after  admitting  these  suppositions 
he  could  not  divest  himself  of  the  suspicion  that  the  London  coic-pox  was  somehow 
or  other  compounded  with  small-pox.  When  Dr.  Jenner  became  fully  ac¬ 
quainted  with  the  manner  of  conducting  the  practice  in  the  small-pox 
hospital,  this  conviction  amounted  to  certainty ;  and  at  a  latter  period  he 
declared  to  Dr.  Woodville  that  the  matter  had  absolutely  been  contaminated 
in  the  hospital.  There  are  facts  to  show  that  this  impure  matter  was  really 
disseminated  over  many  parts  of  England,  and  also  on  the  continent,  in 
place  of  that  of  the  true  variolic  vaccina?. 

Dr.  Eobert  Willan,*  in  his  valuable  work  on  “Vaccine  Inoculation,” 
published  in  1806,  details  in  the  first  section  some  experiments  made  during 
the  years  1799  and  1800,  on  the  combined  inoculation  of  the  variolous  and 
vaccine  fluids. 

From  these  experiments  it  appears  that: 

“  The  variolous  and  vaccine  fluids  inoculated  about  the  same  time,  restrain  the  action  of 
each  other  on  the  human  body,  so  that  in  some  cases  the  vaccine  vesicle  is  smaller  than  us¬ 
ual,  and  has  a  very  slow  progress;  in  ocher  cases  the  areola  is  scarcely  perceptible  ; 
while  in  others  it  is  large  but  premature  ;  and  the  variolous  eruption  consists  of  hard, 
distinct,  shining  pustules,  which  have  but  little  inflammation  round  them,  and  which 
seldom  maturate. 

Some  of  these  pustules  are  tubuculated ;  and  the  small  quantity  of  matter  contained 
in  them  soon  disappears,  leaviug  the  cuticle  which  confined  it,  horny  and  elevated  for 
many  days  afterwards.  The  rest  of  the  eruption  is  minute  and  papulous,  not  suppurat¬ 
ing  but  desquamating.  I  was  fully  satisfied  that  the  pustules,  produced  under  these  cir¬ 
cumstances,  wrere  genuine  variolous  pustules,  as  many  opportunities  occurred  to  me  of 
ascertaining,  by  inoculation  from  them,  that  they  were  capable  of  producing  every 
variety  of  the  small-pox,  from  the  mild  and  distinct,  to  the  confluent  and  more  danger¬ 
ous  form  of  the  disease.  Dr.  Woodville,  who  considered  them  to  be  secondary  vaccine 
pustules  or  vesicles,  often  inoculated  from  them  and  transmitted  to  several  of  iiis  friends  ; 
we  may,  hence,  perhaps,  account  for  the  appearance  of  pustules,  in  persons  supposed  to 
have  been  properly  vaccinated,  in  different  parts  of  the  country.  I  may,  however,  ob¬ 
serve,  that  fluid,  taken  from  the  vaccine  vesicle,  in  the  arm  of  a  person  affected  with 
the  variolous  fever  and  eruption,  and  inserted  in  the  arm  of  another  person  by  a  clean 
lance,  produced  the  vaccine  disease  alone.”  P.  56. 

Dr.  Eobert  Willan,  field  tfiat  tfie  cliief  nicety  and  difficulty  of  vaccina¬ 
tion  is,  in  distinguisfiiug  from  tfie  genuine  cow-pox,  some  irregular  vesicles 
wfiicfi  have  often  been  mistaken  for  it,  and  which  do  not  wholly  secure  tfie 
constitution  from  tfie  small-pox. 

Dr.  Willan  gives  tfie  following  concise  description  of  the  irregular  vac¬ 
cine  vesicles : 


*On  Vaccine  Inoculation.  By  Eobert  Willan,  M.  D.  F.  E.  A.  S.  Physician  Extraordinary  to  the 
Fever  Institution,  and  to  the  Public  Dispensary  in  London,  quarto,  108  pages,  •with  colored  engravings,  and 
an  appendix  of  54  pages.  Philips,  1800. 


Errors  of  Dr.  Woodville,  exposed  by  Jenner  and  Willan 


121 


“I  have  observed  three  sorts  of  these  irregular  vesicles.  The  first  is  a  single  pearl - 
colored  visicle,  set  in  a  hard  dark  red  base,  slightly  elevated.  It  is  larger  and  more 
globate  than  the  spurious  pustule  above  represented,  but  much  less  than  the  genuine  ve¬ 
sicle;  its  top  is  flattened,  or  sometimes  a  little  depressed;  but  the  margin  is  not  rounded 
or  prominent.  The  second  appears  to  be  cellular,  like  the  genuine  vesicle,  but  is  some¬ 
what  smaller  and  more  sessile  and  has  a  sharp  angnlated  edge. 

“In  the  first,  the  areolar  is  usually  diffuse,  and  of  a  dark  rose  color;  in  the  second,  it  is 
somewhat  of  a  dilute  scarlet  color,  radiated  and  very  extensive,  as  from  the  sting  of  a 
wasp;  at  other  times,  it  has  the  form  and  color  exhibited  in  Plate  1,  No.  7.  The  areola  ap¬ 
pears  round  these  vesicles  on  the  seventh  or  eighth  day  after  inoculation,  and  continues 
more  or  less  vivid  for  three  days,  during  which  the  scab  is  completely  formed.  The  scab 
is  smaller,  and  less  regular  than  that  which  succeeds  the  genuiue  vesicle;  it  also  falls  off 
much  sooner;  and,  when  seperated,  leaves  a  smaller  cicatrix  which  is  sometimes  angu- 
lated.  The  third  irregular  appearance  is  a  vesicle  without  an  areola.”  On  Vaccine  In- 
noculation  p.  39-40. 

As  tlie  degree  of  security  afforded  by  these  irregular  vesicles  is  different 
in  different  persons,  and,  as  the  matter  taken  from  them  often  produces  the 
same  imperfect  form  of  the  disease,  it  can  scarcely  be  doubted  that  many 
mistakes  and  failures  originated  from  this  source.  Dr.  Willan  therefore 
suggested  the  propriety  of  confining  the  practice  of  vaccination  to  those 
who  had  had  a  sufficiant  education,  and  who  had  minutely  attended  to  the 
subject.  He  also  further  recommended  a  strict  examination  of  all  persons 
inoculated  between  the  first  of  January,  1799,  and  the  first  of  January, 
1802,  and  urged  the  necessity  of  re-inoculation  in  every  doubtful  case. 

With  reference  to  the  cutaneous  and  glandular  affections  imputed  to  vaccina¬ 
tion ,  Dr.  Willan  did  not  observe  any  new  disease  of  the  skin  referable  to 
the  cow-pox.  Dr.  Willan  endeavored  to  prove  by  a  table,  extracted  from 
the  register  books  of  the  public  dispensary  in  London,  that  the 
number  of  cutaneous  complaints  was  not  increasing,  their  proportion 
to  all  other  diseases  having  been  the  same  before  the  publication  of  Dr. 
Jenner’s  inquiry  as  in  the  sixth  and  seventh  year  of  vaccination.  On 
Vaccine  Inoculation ,  p.  82. 

The  prime  object  of  this  division  of  our  work  on  the  prevention  and  arrest 
of  contagious  and  infectious  diseases,  is  to  present  those  facts  and  original 
documents  which  illustrate  the  history  and  relations  of  small-pox  and  cow- 
pox,  and  which  will  furnish  the  sanitarians,  physicians  and  legislators  of 
Louisanna,  and  of  all  other  States  in  the  American  Union  the  fundamental 
principles  for  the  enactment  of  wise,  just  and  efficacious  regulations  and 
laws  for  the  absolute  arrest  of  the  most  loathsome  and  destructive  pesti¬ 
lence  which  has  ever  afflicted  the  human  race. 

A  minute  analysis  therefore  of  the  various  publications  #  relative  to  vac- 


*  We  append  tlie  following  references  in  order  to  illustrate  the  rich  and  extensive  nature  of  tire  oontribu 
tions  by  various  observers  to  the  literature  of  cow-pox  inoculation  during  the  first  five  years  after  Jenner ’s 
announcement  of  his  discovery  : 

Ur.  Pearson’s  Letter  on  the  Effects  of  Inoculating  the  Vaccine  Disease.  The  London  Medical  Review 
and  Magazine,  by  a  Society  of  Physicians  and  Surgeons,  vol.  1,  March  to  August,  1799,  p.  201,  p.  319. 

I>r.  Woodville’s  JSTote  on  the  Cow-pox,  addressed  to  the  Society  of  Physicians  and  Surgeons.  London  Med- 
Iteview  and  Magazine,  vol.  1,  p  397. 

A  communication  from  Dr.  Hooper,  respecting  the  Susceptibility  of  Persons  Exposed  to  the  Variolous 
Contagion  after  having  had  the  Cow-pox.  London  Medical  Review  and  Magazine,  vol.  1,  1799,  p.  505, 

Extracts  of  Letters  from  Mr.  Cooke,  Apothecary  at  Glocester.  London  Medical  Review  and  Magazine, 
vol.  1,  p.  591. 

Answers  by  Mr.  Jacobs.  Attorney-at-Law,  Bristol,  to  Queries  proposed  by  the  Editor,  respecting  tho 
Cow-pox.  London  Medical  Review  and  Magazine,  vol.  1,  p.  599. 

A  statement  of  the  Progress  in  tho  Vaccine  Inoculation,  and  Experiments  to  determine  some  important 
Facts  belonging  to  the  Vaccine  Disease,  by  George  Pearson,  M.  D.,  F.  R.  S.  Physician  to  St.  George’s 
Hospital,  etc.  London  Medical  Review  and  Magazine,  vol,  1.  p.  612. 

Observations  on  Dr.  Hooper’s  Cases  of  the  Cow-pox,  by  the  Rev.  J.  D.  Fosbrooke,  M.  A.,  Curate  of 
Horsley,  Gloucestershire.  London  Medical  Review  and  Magazine,  vol.  1,  p.  628. 

A  communication  concerning  the  Eruptions  Resembling  the  Small-pox,  which  sometimes  appear  in  the  In¬ 
oculated  Vaccine  Disease,  by  George  Pearson,  M.  D.,  F.  R.  S.,  Physician  to  St.  George’s  Hospital.  Lon¬ 
don  Medical  Review  and  Magazine, ,  September,  1799-1800,  vol.  2,  p.  393, 

An  A  ccount  of  an  Institution  for  Inoculating  the  Vaccine-pock,  patronized  by  His  Royal  Highness  the 
Duke  of  York,  at  No.  36  Warwick  street,  Golden  Square.  London  Medical  Review  and  Magazine,  vol.  2, 
p.  475. 


122  Errors  of  Dr.  Woodville,  evposel  by  Jemmer  and  Wiliam. 


cmation,  would  be  a  useless  waste  of  time,  for  the  essential  facts  will  be 
found  in  the  works  of  the  original  observers  which  have  been,  or  which  will 
be,  dissecated  and  recorded  in  the  progress  of  the  present  vindication  of 
vaccination. 


Remarks  on  Dr.  Pearson’s  communication  concerning  the  Eruptions  resembling  the  Small-pox,  which 
sometimes  appear  in  the  Inoculated  Vaccine  Disease.  By  the  Rev.  E.  D.  Eosbrooke,  M.  A.  E.  A.  S.,  Cu¬ 
rate  of  Horsley,  Gloucestershire.  London  Medical  Review  and  Magazine,  vol.  2,  p.  431. 

Observations  on  the  Cow-pox.  By  Mr- John  Chapman,  Surgeon  at  Ampthill,  Bedfordshire;  communi¬ 
cated  by  Dr.  Pearson.  M,  D.,  E.  R.  S.  London  Medical  Review  and  Magazine,  March  to  June,  1800,  vol. 

3,  p.  77. 

Translation  of  a  letter  from  Mr.  Stromeger  to  Mr.  Hunneman,  concerning  the  Vaccine  Inoculation  prac¬ 
ticed  by  him;  dated  Hanover,  March  24,  1800.  London  Medical  Review  and  Magazine,  vol.  3,  p.  174. 

Information  relating  to  the  Cow-pox ;  communicated  by  Mr,  R.  J.  Taynton,  Surgeon  at  Bromley,  in  Kent. 
London  Medical  Review  and  Magazine,  vol.  3,  p,  179. 

Cases  and  Observations  tending  to  prove  either  the  Infectious  Rat ure  of  the  Cow-pox,  or  the  fallacy  of 
some  experiments  made  in  London.  By  Mr.  Blair,  Surgeon  of  the  Lock  Hospital  and  Ferisbury  Dispensary, 
etc.  London  Medical  Review  and  Magazine,  -vol.  3,  p.  188. 

Remarks  on  Mr.  Blair’s  paper  concerning  the  Infectious  Nature  of  Cow-pox,  and  on  that  of  Mr.  Taynton 
relative  to  the  same  subject.  By  John  Resig,  Member  of  the  Royal  College  of  Surgeons  in  London.  Lon¬ 
don  Medical  Review  and  Magazine,  1800,  vol.  3,  p.  312. 

Notice  relating  to  the  Cow-pox  Institution.  London  Medical  Rev  lew  and  Magazine,  vol .  3,  p .  316, 
Observations  on  Certain  Peculiarities  of  the  Cow-pox.  By  Mr.  John  Resig,  Member  of  the  Royal  College 
of  Surgeons;  with  Additional  Remarks  by  the  Editors.  Loudon  Medical  Review  and  Magazine,  vol.  3,  p. 
417. 

Notice  of  a  Testimonial  in  Eavor  of  the  Cow-pox  ;  signed  by  several  Physicians  and  Surgeons  in  London, 
June,  1800.  London  Medical  Review  and  Magazine,  vol.  3,  p.  420. 

Further  Remarks  on  the  Infectious  Nature  of  the  Cow-pox.  By  Mr.  Blair,  Surgeon  of  the  York  Hospital 
and  Asylum,  and  of  the  Ferisbury  Dispensary,  etc.  London  Medical  Review  and  Magazine,  vol.  3,  p.  421. 

Some  further  Observations  and  Experiments  on  the  Vaccine  Inoculation.  By  G.  Pearson,  M.  D.,  E.  R.  S., 
London,  Physician  to  St.  George’s  Hospital,  London  ;  in  a  letter  to  Dr.  Duncan.  London  Medical  Review 
and  Magazine,  vol.  3,  p.  78. 

Reflections  on  the  Cow-pox,  illustrated  by  cases  to  prove  it  an  absolute  security  against  the  small-pox. 
Addressed  to  the  public  in  a  letter  to  Dr.  lenner,  from  William  Eermor,  Esq.,  octavo,  47  pages;  Robson, 
London.  1800. 

The  vaccine  matter  employed  by  Mr.  Eermor  was  originally  derived  from  the  Rev.  Mr.  Jenner,  of  Berk¬ 
ley.  The  total  number  of  his  cow-pox  patients  amounted  to  326,  of  which  number,  173  were  afterwards 
inoculated  with  the  small-pox  without  taking  the  infection .  In  only  two  instances  did  any  vaccine,  erup¬ 
tions  appear,  except  on  the  inoculated  part ;  a  single  jmstule  on  the  forehead  of  one,  and  iikewise  one  on 
the  arm  of  another. 

An  Address  to  the  Public  on  the  Advantages  of  Vaccine  Inoculation  ;  with  the  objections  to  it  refuted. 
By  Henry  Jenner,  Surgeon,  F.  L.  S  ,  etc.,  quarto,  19  pages  ;  Cadell  &  Davies,  Loudon. 

Some  Observations  on  Vaccination,  or  the  Inoculation  of  Cow-pox.  By  Richard  Dunning,  Surgeon, 
Plymouth  Dock,  and  Member  of  the  Medical  Society  of  that  Town  and  Plymouth,  octavo,  122  pages;  Cadell 
&  Davies,  London,  1800. 

Observations  on  the  Cow-pox.  By  William  Woodville,  M.  D.,  Physician  to  the  Small-pox  and  Inocula¬ 
tion  Hospitals,  octavo,  43  pages  ;  Phillips,  London,  1800. 

Copy  of  a  Testimonial  in  favor  of  the  Vaccine  Inoculation,  signed  by  thirty-six  Physicians  and  Sur 
geons  in  London.  London  Medical  Review  and  Magazine,  vol.  4.  July  to  December,  1800,  p.  60. 

Further  infoimation  respecting  the  case  of  Cow-pox  which  was  lately  communicated  by  Mr.  Malim,  with 
observations  by  the  Editor.  London  Medical  Review  and  Magazine,  vol,  4,  1800,  p.  208.' 

Additional  Observations  on  the  Variform  Eruptions  which  have  occurred  in  the  Cow-pox,  with  some  fur¬ 
ther  remarks  on  the  origin  of  the  disease.  By  Mr.  Ring,  Member  of  the  Royal  College  of  Surgeons  in 
London.  London  Medical  Review  and  Magazine,  July  to  October,  1800,  vol.  4.  p.  91. 

On  the  Introduction  of  the  Vaccine  Inoculation  ait  Paris  (A.  Monsieur  Pearson,  Medecin  de  l’Hopital 
de  rinoeulation  Vaccine  a  Londres).  London  Medical  Review  and  Magazine,  vol.  4,  p.  204. 

Further  Remarks  on  Variolated  Vaccine  Matter,  and  on  Mr.  Malim ’s  case  of  Cow-pox.  By  Mr.  Ring, 
Member  of  the  Royal  College  of  Surgeons  in  London.  London  Medical  Review  and  Magazine,  vol.  4.  p. 
307.  „  . 

Facts  relating  to  the  origin  of  the  Cow-pox,  communicated  by  Sir  Christopher  Pegge,  Knight,  M.  D.,  and 
Reader  of  Anatomy,  Oxford.  London  Medical  Review  and  Magazine,  November,  1800,  to  ‘'February,  1801, 
vol.  5,  p.  76. 

Authentic  information  relative  to  some  extraordinary  cases  of  the  Cow-pox  at  Clapham.  By  Mr.  Pears, 
F.  M.  S.,  etc.;  with  a  postscript  by  the  Editors.  London  Medical  Review  and  Magazine,  vol.  5,  p.  276. 

Facts  concerning  the  Eruptions  and  Contagious  Nature  of  the  Cow-pox.  By  Mr.  Harrup,  of  Cholsham. 
London  Medical  Review  and  Magazine,  vol.  5,  p.  289. 

Rapport  sur  la  Vaccine  ;  ou  Reponse  aux  Questions  Redigees  paries  Commissaires  de  1’Ecole  de  Mede- 
cine  de  Paris,  sur  la  Pratique  et  les  Resultats  de  cete  Nouvelle  Inoculation  en  Angleterre,  et  dans  les  Hos¬ 
pices  des  Londres,  ou  on  l’Adoptd  Par  A  Aubert,  Docteur  en  Medecine  ;  Paris,  An  9. 

Copy  of  a  letter  ou  the  Cow-pox,  from  Dr.  Marshall  to  Mr.  Ring,  dated  Gibralter,  August  23,  1800. 
London  Medical  Review  and  Magazine,  vol.  5.  p.  100. 

A  Concise  View  of  Circumstances  and  Proceedings  respecting  Vaccine  Inoculation,  etc.,  etc.  London, 
1800 . 

A  concise  view  of  all  the  most  important  facts  which  have  hitherto  appeared  concerning  the  Cow-pox. 
By  C.  It.  Aikin,  Member  of  the  Royal  College  of  Surgeons  in  London  ;  Phillips,  London,  1800. 

A  comparative  statement  of  Facts  and  Observations  relative  to  the  Cow-pox ;  published  byDrs.  Jenner 
and  Woodville,  London,  1800. 

Copy  of  a  letter  from  Dr.  Marshall  to  Mr.  Ring,  dated  Mahon,  Island  of  Miaorrca,  September,  1800. 
London  Medical  Review  and  Magazine,  vol.  5,  p  198. 

Copy  of  a  letter  from  Dr.  Marshall  to  Mr.  Ring,  dated  H.  M.  S.  Fondrazars,  Gibraltar  Bay,  October  16, 
1  800 .  London  Medical  Review  and  Magazine,  vol .  5,  p .  199. 

Additional  Signatures  to  the  Testimonial  in  favor  of  Vaccine  Inoculation.  London  Medical  Review  and 
Magazine,  vol.  5,  p  315. 


123 


Reports  on  Vaccination  by  British  Physicians ,  1807. 


That  the  labors  of  Dr.  Jcnuer  were  recognized  by  the  wisest  and  most 
able  representatives  of  his  own  country,  within  ten  years  after  the  an¬ 
nouncement  of  his  discovery,  is  shown  by  the  following’  report  of  the  Eoyal 
College  ot  Physicians  of  London,  on  vaccination  in  1807. 

This  report,  with  the  accompanying  opinions  of  the  Eoyal  College  of 
Physicians  of  Edinburgh  and  Dublin,  and  of  the  Eoyal  College  of  Sur¬ 
geons  of  London,  of  Dublin  and  of  Edinburgh,  made  in  accordance  with 
an  address  from  the  House  of  Commons  and  in  compliance  with  the  com¬ 
mands  of  the  King  of  England,  should  be  regarded  as  one  of  the  ablest 
and  most  impartial  of  the  testimonials  which  have  at  different  times  and 
in  different  countries  been  received  in  favor  of  vaccination. 


EEPOET  OF  THE  EOYAL  COLLEGE  OF  PHYSICIANS  OF  LON¬ 
DON,  ON  VACCINATION.  WITH  AN  APPENDIX,  CONTAIN¬ 
ING  THE  OPINIONS  OF  THE  EOYAL  COLLEGE  OF  PHYSI¬ 
CIANS  OF  EDINBUEGH  AND  DUBLIN;  AND  OF  THE  EOYAL 
COLLEGES  OF  SUEGEONS  OF  LONDON,  OF  DUBLIN,  AND 
OF  EDINBUEGH. 

The  Royal  College  of  Physicians  of  London,  having  received  his  Majesty’s  commands, 
in  compliance  with  an  address  from  the  House  of  Commons,  “to  inquire  into  the  state  of 
vaccine  inoculation  in  the  United  Kingdom,  to  report  their  opinion  and  observations  up¬ 
on  that  practice,  upon  the  evidence  which  has  been  adduced  in  its  support,  and  upon 
the  causes  which  have  hitherto  retarded  its  general  adoption  have  applied  themselves 
diligently  to  the  business  referred  to  them. 

Deeply  impressed  with  the  importance  of  an  inquiry  which  equally  involves  the  lives 
of  individuals  and  the  public  prosperity,  they  have  made  every  exertion  to  investigate 
the  subject  fully  and  impartially.  In  aid  of  the  knowledge  and  experience  of  the  mem¬ 
bers  of  their  own  body,  they  have  applied  separately  to  each  of  the  Licentiates  of  the 
college;  they  have  corresponded  with  the  Colleges  of  Physicians  of  Dublin  and  Edin¬ 
burgh;  with  the  Colleges  of  Surgeons  of  London  Edinburgh  and  Dublin;  they  have 
called  upon  the  societies  established  for  vaccination,  for  an  account  of  their  practice,  to 
what  extent  it  has  been  carried  on,  and  what  has  been  the  result  of  their  experience; 
and  they  have,  by  public  notice,  invited  individuals  to  contribute  whatever  information 
they  had  severally  collected.  They  have  in  consequence  been  furnished  with  a  mass  of 
evidence  communicated  with  the  greatest  readiness  and  candor,  which  enables  them  to 
speak  with  confidence  upon  all  the  principal  points  referred  to  them, 

I.  During  eight  years  which  have  elapsed  since  Dr.  Jenner  made  his  discovery  public 
the  progress  of  vaccination  has  been  rapid,  not  only.in  all  parts  of  the  United  Kingdom, 
but  in  every  quarter  of  the  civilized  world.  In  the  British  Islands  some  hundred  thous¬ 
ands  have  been  vaccinated;  in  our  possession  in  the  East  Indies  upwards  of  800,000,  and 
among  the  nations  of  Europe  the  practice  has  become  general.  Professional  men  have 
submitted  it  to  the  fairest  trials,  and  the  public  have,  for  the  most  part,  received  it  with¬ 
out  prejudice.  A  few  indeed  have  stood  forth  the  adversaries  of  vaccination,  on  the  same 

The  Report  of  the  Cow-pock  Inoculation  from  the  Practice  at  the  Vaccine  Pock  Institution,  during  the 
years  1800,  1801  and  1802.  Read  at  the  General  Meeting  of  the  Governors  February  7,  1803,  at  the  Shaks- 
peare  Tavern  :  written  by  the  Physicians  to  the  Institution  ;  to  which  are  prefixed  two  painted  engravings 
of  Cow-pox  and  other  Eruptions.  London,  1803. 

Third  Annual  Report- of  the  Vaccine  Pock  Institution  for  Inoculating  the  Poor,  Supported  by  the  Vol- 
untary  Subscriptions,  Benefactions  and  legacies  of  the  Public  ;  From  its  Foundation,  December  2,  1800,  to 
December  31,  1802. 

A  case  showing  the  impropriety  of  taking  the  whole  of  the  virus  out  of  a  vaccine  vesicle;  communicated 
by  Dr.  Frederick  Dalcho,  Secretary  to  >  v  Medical  Society  of  South  Carolina,  to  Dr.  Michell,  April  27, 1805. 
The  Medical  Repository,  etc.,  vol  3,  p.  2ti4. 

Tile  cases  reported  by  I)r.  Frederick  Dalcho,  occurred  in  May,  1802. 

“  Remarks  on  the  Cow-pox  Inoculation,  by  Mr.  Charles  Brandon  Frye.” 

From  his  own  experience  Mr.  Frye  asserted,  first,  that  whatever  has  been  said  against  the  sufficiency  of 
Cow-pox  matter,  as  a  security  against  variolous  infection,  may  be  also  said  with  truth  against  Small-pox  mat¬ 
ter,  as  a  similar  security  ;  second,  that  the  subsequent  ill  effects  which  have  been  said,  to  follow  Cow-pox, 
have,  in  a  ten-fold  degree,  followed  Small  pox  ;  third,  that  many  instances  of  mortality  have  happened  in 
Small-pox  inoculation,  while  amongst  all  which  has  been  said,  not  a  single  example  appears  of  death  from 
Cow-pox. 


124 


Reports  on  Vaccination  by  British  Physicians ,  1807. 


grounds  as  their  predecessors  who  opposed  the  inoculation  for  the  small-pox,  falsely  led 
by  hypothetical  reasoning  in  the  investigation  of  a  subject  which  must  be  supported,  or 
rejected,  upon  facts  and  observation  only.  With  these  few  exceptions,  the  testimony 
in  favor  of  vaccination  has  been  most  strong  and  satisfactory,  and  the  practice  of  it, 
though  it  has  received  a  check  in  some  quarters,  appears  still  to  he  upon  the  increase  in 
most  ports  of  the  United  Kingdom. 

II.  The  College  of  Physicians,  in  giving  their  observations  and  opinions  on  the  prac¬ 
tice  of  vaccination,  think  it  right  to  premise,  that  they  advance  nothing  but  what  is 
supported  by  the  multiplied  and  unequivocal  evidence  which  1ms  been  brought  before 
them,  and  they  have  not  considered  any  facts  as  proved,  but  what  have  been  stated  from 
actual  observation. 

Vaccination  appears  to  be  in  general  perfectly  safe;  the  instances  to  the  contrary  being 
extremely  rare.  The  disease  excited  by  it  is  slight,  seldom  preventing  those  under  it  from 
following  their  ordinary  occupations.  It  has  been  communicated  with  safety  to  pregnant 
women,  to  children  during  dentition,  and  in  their  earliest  infancy;  in  all  which  respects 
it  possesses  material  advantages  over  inoculation  for  the  small-pox;  which,  though  pro¬ 
ductive  of  a  disease  generally  mild,  yet  sometimes  occasion  alarming  symptoms,  and  is 
in  a  few  cases  fatal. 

The  security  derived  from  vaccination  against  the  small-pox,  if  not  absolutely  perfect 
is  as  nearly  so  as  can  perhaps  be  expected  from  any  human  discovery;  for  amonst  several 
hundred  thousand  cases,  with  the  results  which  the  College  have  been  made  acquainted, 
the  number  of  alleged  failures  have  been  surprisingly  small,  so  much  so,  as  to  form  cer¬ 
tainly  no  reasonable  objection  to  the  general  adoption  of  vaccination,  for  it  appears  that 
there  is  not  nearly  so  many  failures  in  a  given  number  of  vaccinated  persons,  as  there 
are  deaths  in  an  equal  number  of  persons  inoculated  for  the  small-pox.  Nothing  can 
more  deary  demonstrate  the  superiority  of  vaccination  over  the  ‘inoculation 
of  the  small-pox,  than  this  consideration  ;  and  it  is  a  most  important  fact, 
which  has  been  confirmed  in  the  course  of  this  inquiry,  that  in  almost  every 
case  where  the  small-pox  has  succeeded  vaccination,  whether  by  inoculation  or  by  causul 
infection,  the  disease  has  varied  much  from  its  ordinary  course;  it  has  neither  been  the 
same  in  violence,  nor  in  the  duration  of  its  symptoms,  but  has,  with  very  few  exceptions 
been  remarkably  mild,  as  if  the  small-pox  had  been  deprived,  by  the  previous  vaccine 
disease,  of  all  its  usual  malignity.  * 

The  testimonies  before  the  College  of  Physicians  are  very  decided  in  declaring,  that 
vaccination  does  less  mischief  to  the  constitution  and  less  frequently  gives  rise  to  other 
diseases,  than  small-pox,  either  natural  or  inoculated.  *  _ 

The  College  feel  themselves  called  upon  to  state  this  strongly,  because  it  has  been  ob¬ 
jected  to  vaccination,  that  it  produces  new,  unheard-of,  and  monstrous  diseases.  Of 
such  assertions  no  proofs  have  been  produced,  and,  after  diligent  inquiry,  the  College 
believe  them  to  have  been  either  the  inventions  of  designing,  or  the  mistakes  of  ignorant 
men.  In  these  respects  then,  in  its  mildness,  its  safety,  and  its  consequences,  the  in¬ 
dividual  may  look  for  the  peculiar  advantages  of  vaccination.  The  benefits  which  flow 
from  it  to  society  are  infinitely  more  considerable;  it  spreads  no  infection,  and  can 
be  communicated  only  by  inoculation.  It  is  from  a  consideration  of  the  pernicious  effects 
of  the  small-pox,  that  the  real  value  of  vaccination  is  to  be  estimated.  The  natural 
small-pox  has  been  supposed  to  destroy  a  sixth  part  of  all  whom  it  attacks  ;  and  that 
even  by  inoculation,  where  that  has  been  general  in  parishes  and  towns,  about  one  in 
300  has  usually  died.  It  is  not  sufficiently  known,  or  not  adverted  to,  that  nearly  one- 
tenth,  some  years  more  than  one-tfenth  of  the  whole  mortality  in  London,  is  occasioned 
by  the  small-pox  ;  and  however  beneficial  the  inoculation  of  the  small-pox  may  have  been 
to  individuals,  it  appears  to  have  kept  up  a  constant  source  of  contagion,  which  has 
been  the  means  of  increasing  the  number  of  deaths  by  what  is  called  the  natural  disease. 
It  cannot  be  doubted  that  this  mischief  has  been  extended  by  the  inconsiderate  manner 
in  which  great  numbers  of  persons,  even  since  the  introduction  of  vaccination,  are  still 
every  year  inoculated  with  the  small-pox,  and  afterwards  required  to  attend  two  or 
three  times  a  week  at  the  places  of  inoculation,  through  every  stage  of  their  illness. 

From  this,  then,  the  public  are  to  expect  the  great  and  uncontroverted  superiority  of 
vaccination,  that  it  communicates  no  casual  infection,  and,  while  it  is  a  protection  to 
the  individual, it  is  not  prejudicial  to  the  public. 

III.  The  College  of  Physicians,  in  reporting  their  observations  and  opinions  on  the 
evidence  adduced  in  support  of  vaccination,  feel  themselvos  authorized  to  state  that  a 
body  of  evidence  so  large,  so  temperate,  and  so  consistent,  was  perhaps  never  before  col¬ 
lected  upon  any  medical  question.  A  discovery  so  novel,  and  to  which  there  was  noth¬ 
ing  analogous  known  in  nature,  though  resting  on  the  experimental  observations  of  die 
inventor,  was  at  first  received  with  diffidence  ;  it  was  not,  however,  difficult  for  others 
to  repeat  his  experiments,  by  which  the  truth  of  his  observations  was  confirmed,  and  the 
doubts  of  the  cautious  were  gradually  dispelled  by  extensive  experience.  At  the  com¬ 
mencement  of  the  practice,  almost  all  that  were  vaccinated  were  afterwards  submitted  to 


Reports  on  Vaccination  by  British  Physicians,  1807. 


125 


the  inoculation  of  the  small-pox,  many  underwent  this  operation  a  second,  and  even  a 
third  time,  and  the  uniform  success  of  these  trials  quickly  bred  confidence  in  the  now 
discovery.  But  the  evidence  of  the  security  derived  from  vaccination  against  the  small¬ 
pox  does  not  rest  alone  upon  those  who  afterwards  underwent  variolous  inoculation,  al¬ 
though  amounting  to  many  thousands  ;  for  it  appears,  from  numerous  observations  com¬ 
municated  to  the  College,  that  those  who  have  been  vaccinated  are  equally  secure  sgainst 
the  small-pox  does  not  rest  alone  upon  those  who  afterwards  underwent  variolous  inocu¬ 
lation,  although  amounting  to  many  thousands;  for  it  appears,  from  numerous  observa¬ 
tions  communicated  to  the  College,  that  those  who  have  been  vaccinated  are  equally  se¬ 
cure  against  the  contagion  of  epidemic  small-pox.  Towns,  ’indeed,  and  districts  of  the 
country,  in  which. vaccination  had  been  general,  have  afterwards  had  the  small-pox 
prevalent  on  all  sides  of  them  without  suffering  from  the  contagion.  There  are  also  in 
the  evidence  a  few  examples  of  epidemic  small-pox  having  been  subdued  by  a  general 
vaccination.  It  will  not,  therefore,  appear  extraordinary  that  many  who  have  commu¬ 
nicated  their  observations  should  state,  that  though  at  first  they  thought  unfavorably  of 
the  practice,  experience  had  now  removed  all  their  doubts. 

It  has  been  already  mentioned  that  the  evidence  is  not  universally  favorable,  although 
it  is  in  truth  nearly  so,  for  there  are  a  few  who  entertain  sentiments  differing  widely 
from  those  of  the  great  majority  of  their  brethren.  The  College,  therefore,  deemed  it 
their  duty,  in  a  particular  manner,  to  inquire  upon  what  grounds  and  evidence  the  op- 
posers  of  vaccination  rested  their  opinions.  From  personal  examination,  as  well  as  from 
their  writings,  they  endeavored  to  learn  the  full  extent  and  weight  of  their  objections. 
They  found  them  without  experience  in  vaccination,  supporting  their  opinions  by  hear¬ 
say  information  and  hypothetical  reasoning;  and,  upon  investigating  the  facts  which 
they  advanced,  they  found  them  to  be  either  misapprehended  or  misrepresented,  or  flint 
they  fell  under  the  description  of  cases  of  imperfect  small-pox  before  noticed,  and  which 
the  College  have  endeavored  fairly  to  appreciate. 

The  practice  of  vaccination  is  but  of  eight  years  standing,  and  its  promoters,  as  well 
as  opponents,  must  keep  in  mind  that  a  period  so  short  is  too  limited  to  ascertain  every 
point,  or  to  bring  the  art  to  that  perfection  of  which  it  may  be  capable.  The  truth  of 
this  will  readily  be  admitted  by  those  acquainted  with  the  history  of  inoculation  for  the 
small-pox.  Vaccination  is  now,  however,  well  understood,  and  its  character  accurately 
described.  Some  deviations  from  the  usual  course  have  occasionally  occurred,  which  the 
author  of  the  practice  has  called  spurious  cow-pox,  by  which  the  public  have  been 
misled,  as  if  there  were  a  true  and  false  cow-pox;  but  it  appears  that  nothing  more  was 
meant  than  to  express  irregularity  or  difference  from  that  common  form  and  progress  of 
the  vaccine  pustule  from  which  its  efficacy  is  inferred.  Those  who  perform  vaccination 
ought,  therefore,  to  be  well  instructed,  and  should  have  watched  with  the  greatest  care 
the  regular  progress  of  the  pustule,  and  learnt  the  most  proper  time  for  taking  the  mat¬ 
ter.  .There  is  little  doubt  that  some  of  the  failures  are  to  be  imputed  to  the  inexperience 
of  the  early  vaccinators,  and  it  is  not  unreasonable  to  expect  that  further  observations 
will  yet  suggest  many  improvements  that  will  reduce  the  number  of  anomalous  cases, 
and  furnishing  the  means  of  determining  with  greater  precision,  when  t he  vaccine  dis¬ 
ease  has  been  effectually  received. 

Though  the  College  of  Physicians  have  confined  themselves  in  estimating  the  evidence 
of  such  facts  as  have  occurred  in  their  own  country,  because  the  accuracy  of  them  could 
best  be  ascertained,  they  cannot  be  insensible  to  the  confirmation  these  receive  from  the 
reports  of  the  successful  introduction  of  vaccination,  not  only  into  every  part  of  Europe, 
but  throughout  the  vast  continents  of  Asia  and  America. 

IV.  Several  causes  have  had  a  partial  operation  in  retarding  the  general  adoption  of 
vaccination  ;  some  writers  have  greatly  underrated  the  security  it  affords,  while  others 
have  considered  it  to  be  of  a  temporary  nature  only;  but  if  any  reliance  is  to  be  placed 
on  the  statements  which  have  been  laid  before  the  College,  its  power  of-protecting  the 
human  body  from  the  small-pox,  though  not  perfect  indeed,  is  abundantly  sufficient  to 
recommend  it  to  the  prudent  and  dispassionate,  especially  as  the  small-pox,  in  the  few 
instances  where  it  has  subsequently  occurred,  has  been  generally  mild  and  transient. 
The  opinion  that  vaccination  affords  but  a  .temporary  security  is  supported  by  noanology 
in  nature,  nor'by  the  facts  which  have  hitherto  occurred.  Although  the  experience  of 
vaccine  inoculation  be  only  of  a  few  years,  yet  the  same  disease,  contracted  by  the 
milkers  of  cows,  in  some  districts,  has  been  long  enough  known  to  ascertain  that  in  them, 
at  least,  the  unsusceptible  of  the  cow-pox  contagion  does  not  wear  out  of  time.  Another 
cause  is  the  charge  against  vaccination  of  producing  various  new  diseases  of  frightful 
and  monstrous  appearance. 

Representations  of  some  of  these  have  been  exhibited  in  print  in  a  way  to  alarm  the 
feelings  of  parents,  and  to  infuse  dread  and  apprehension  into  the  minds  of  the  unin¬ 
formed.  Publications  with  such  representations  have  been  widely  circulated,  ancl^ 
though  they  originate  either  in  gross  ignorance,  or  willful  misrepresentation,  yet  have 
they  lessened  the  confidence  of  many,  particularly  of  the  lower  classes,  in  vaccination  ; 


126 


Reports  on  Vaccination  by  British  Physicians ,  1807. 

* 

no  permanent  effects,  however,  in  retarding  tlie  progress  of  vaccination  need  be  appre¬ 
hended  from  such  causes,  for,  as  soon  as  the  public  shall  view  them  coolly  and  without 
surprise,  they  will  excite  contempt,  and  not  fear. 

Though  the  College  of  Physicians  are  of  opinion  that  the  progress  of  vaccination  has 
been  retarded  in  a  few  places  by  the  above  causes,  yet  they  conceive  that  its  general 
adoption  has  been  prevented  by  causes  far  more  powerful,  and  of  a  nature  wholly  differ¬ 
ent.  The  lower  orders  of  society  can  hardly  be  induced  to  adopt  yirecautions  against 
evi  s  which  may  be  at  a  distance  :  nor  can  it  be  expected  from  them,  if  these  precautions 
are  attended  with  expense.  Unless,  therefore,  from  the  immediate  dread  of  epidemic 
small-pox,  neither  vaccination  nor  inoculation  appear  at  any  time  to  have  been  general, 
and  when  the  cause  of  terror  has  passed  by,  the  public  have  relapsed  again  into  a  state 
of  indifference  and  apathy,  and  the  satutary  practice  has  come  to  a  stand.  It  is  not  easy 
to  suggest  a  remedy  for  an  evil  so  deeply  imprinted  in  human  nature.  To  inform  and 
instruct  the  public  mind  may  do  much,  and  it  will  probably  be  found  that  the  progress  of 
vaccination  in  different  parts  of  the  United  Kingdom  will  be  in  proportion  to  that  in¬ 
struction.  Were  encouragement  given  to  vaccination,  by  offering  it  to  the  poorer  classes 
without  expense,  there  is  little  doubt  that  it  would  in  time  supersede  the  .inoculation  for 
the  small-pox,  and  thereby  various  sources  of  variolous  infection  would  be  cut  off;  but 
till  vaccination  becomes  general,  it  will  be  impossible  to  prevent  the  constant  recurrence 
of  the  natural  small-pox  by  the  means  of  those  who  are  inoculated,  except  it  should  ap¬ 
pear  proper  to  the  legislature  to  adopt,  in  its  wisdom,  some  measure  by  which  those  who 
still,  from  terroror  prejudice,  prefer  the  small-pox  to  the  vaccine  disease,  may,  in  thus 
consulting  the  gratification  of  their  own  feelings,  be  prevented  from  doing  mischief  to 
their  neighbors. 

From  the  whole  of  the  above  considerations,  the  College  of  Physicians  feel  it  their 
duty  strongly  to  recommend  the  practice  of  vaccination.  They  have  been  led  to  -this 
conclusion  by  no  preconceived  opinion,  but  by  the  most  unbiased  judgment,  formed  from 
an  irresistabfe  weight  of  evidence,  which  has  been  laid  before  them.  For  when  the 
number,  the  respectability,  the  disinterestedness  and  the  extensive  experience  of  its  ad¬ 
vocates  is  compared  with  the  feeble  and  imperfect  testimonies  of  its  few  opposers  ;  and 
when  it  is  considered  that  many,  who  were  once  adverse  to  vaccination,  have  been  con¬ 
vinced  by  further  trials,  and  are  now  to  be  rauked  among  its  warmest  supporters,  the 
truth  seems  to  be  established  as  firmly  as  the  nature  of  such  a  question  admits;  so  that 
i  lie  College  of  Physicians  conceive  that  the  public  may  reasonably  look  forward  with 
some  degree  of  hope  to  the  time  when  all  opposition  shall  cease,  and  the  general  con¬ 
currence  of  mankind  shall  at  length  be  able  to  put  an  end  to  the  ravages,  at  least,  if  not 
to  the  existence,  of  small-pox.  LUCAS  PEPYS,  President, 

Royal  College  of  Physicians,  April  10,  1807. 

JA.  HAEVFY,  Register.  ' 


APPENDIX. 


NO.  1. 

To  the  Eoyal  College  of  Physicians  of  London  : 

Gentlemen — I  am  ordered  by  the  King  and  Queen’s  College  of  Physicians,  in  Ireland,  to 
thank  the  Royal  College  of  Physicians,  of  London,  for  the  communication  they  have 
had  the  honor  to  receive  from  them,  of  certain  propositions  relative  to  vaccination, 
whereon  His  Majesty  has  been  pleased  to  direct  an  inquiry  to  be  instituted,  and  in  the 
prosecution  of  which  the  co-operation  of  the  College  in  Ireland  is  requested. 

And  I  am  directed  to  acquaint  you  that  the  said  College  having  referred  the  investiga¬ 
tion  of  these  propositions  to  a  committee,  have  received  from  them  a  report,  of  which 
the  inclosed  is  a  copy  ;  and  that  they  desire  the  same  may  be  considered  as  containing 
their  opinion  upon  the  subject.  I  have  the  liouor  to  be,  gentlemen, 

Your  most  obedient  humble  servant, 

HUGH  FERGUSON,  Register. 

By  order  of  the  King  and  Queen’s  College  of  Physicians  in  Ireland. 

Dublin,  Nov.  11,  180(5. 


“  The  practice  of  vaccination  was  introduced  in  this  city  about  the  beginning  of  the 
year  1801,  and  appears  to  have  made  inconsiderable  progress  at  first.  A  variety  of 
•  causes  operated  to  retard  its  general  adoption,  amongst  which  the  novelty  of  the  prac¬ 
tice,  and  the  extraordinary  effects  attributed  to  vaccination,  would  naturally  take  the. 
lead. 


12? 


Reports  on  Vaccination  by  British  Physicians ,  1807. 


“Variolous  inoculation  liad  been  long,  almost  exclusively,  in  the  hands  of  a  particular 
branch  ol  the  profession,  whose  prejudices  and  interests  were  strongly  opposed  to  the 
new  practice  ;  and  by  their  being  the  usual  medical  attendants  in  families,  and  espec¬ 
ially  employed  in  the  diseases  of  children,  their  opinions  had  greater  effect  upon  the 
minds  of  parents.  The  small-pox  is  rendered  a  much  less  formidable  disease  in  this 
country  by  the  frequency  of  inoculation  for  it,  than  it  is  in  other  parts  of  His  Majesty’s 
dominions,  where  prejudices  against  inoculation  have  prevailed  ;  hence,  parents  not  un¬ 
naturally,  objected  to  the  introduction  of  a  new  disease,  rather  than  not  recur  to  that 
with  the  mildness  and  safety  of  which  they  were  well  acquainted 

“In  the  beginning  of  the  year  1804,  the  Cow-Pox  Institution  was  established,  under 
the  patronage  of  the  Earl  of  Hardwicke,  and  it  is  from  this  period  that  we  may  date  the 
general  introduction  of  vaccination  into  this  city,  and  throughout  all  parts  of  Ireland. 

“  The  success  of  the  institution,  in  forwarding  the  new  practice,  is  to  be  attributed  in 
a  great  measure  to  the  respectability  ol  the  gentlemen  who  superintend  it  and  to  the 
diligence,  zeal  and  attention  of  Dr.  Labatt,  their  secretary  and  inoculator.  ’in  order  to 
show  the  progress  which  has  been  made  in  extending  the  vaccination,  your  committee 
reler  to  the  report  of  the  Cow-Pox  Institution  for  the  last  two  years,  and  to  extracts 
from  their  Register  for  the  present  year  : 


YEAR. 

Patients 

Inoculated. 

Packets  Issued 
to  Practitioners 
in  General. 

Packets  to 
Army  Surgeons. 

1804 . 

578 

776 

236 

1805 .  . 

1032 

1124 

178 

1806  . 

1356 

1340 

220 

Total „  _ .  . 

6 - 

2966 

3240 

634 

“  lu  the  above  statement  the  numbers  are  averaged  to  the  end  of  the  present  vear,  on 
the  supposition  of  patients  resorting  to  the  institution  as  usual.  The  correspondence  of 
the  institution  appears  to  be  very  general  throughout  every  part  of  Ireland,  and  by  ac¬ 
counts  received,  as  well  from  medical  practitioners  as  others,  the  success  of  vaccination 
seems  to  be  uniform  and  effectual.  At  the  present  period,  in  the  opinion  of  your  com¬ 
mittee,  tlieie  are  tew  individuals  in  auy  branch  of  the  profession  who  oppose  the  prac¬ 
tice  of  vaccination  in  this  part  of  His  Majesty’s  dominions. 

It  is  the  opinion  ot  your  committee  that  the  practice  of  cowr-pox  inoculation  is  safe, 
and  that  it  fully  answers  all  the  purposes  that  have  been  intended  by  its  introduction. 
At  the  same  time,  your  committee  is  willing  to  allow  that  doubtful  cases  have  been  re¬ 
ported  to  them  as  having  occurred,  of  persons  suffering  from  small-pox,  who  had  been 
previously  vaccinated.  Upon  minute  investigation,  however,  it  has  been  found  that 
these  supposed,  instances  originated  generally  in  error,  misrepresentation,  or  the  difficulty 
ot  discriminating  between  small-pox  and  other  eruptions,  no  case  having  come  to  the 
knowledge  ol  your  committee,  duly  authenticated  by  respectable  and  competent  judges, 
of  genuine  small-pox  succeeding  the  regular  vaccine  disease. 

I  he  practice  ot  vaccination  becomes  every  day  more  extended  ;  and,  when  it  is  con¬ 
sidered  that  the  period  at  which  it  came  into  general  use  in  Ireland  is  to  be  reckoned 
from  so  late  a  date,  your  committee  is  of  opinion  that  it  has  made  as  rapid  a  progress  as 
could  be  expected.  L Signed]  “  JAMES  CLEGHORN, 

“DANIEL  MILLS, 

-  “HUGH  FERGUSON.” 

NO.  II. 

Physician’s  Hall,  Edinburgh,  November  26,  1807. 

Gentlemen —  The  Royal  College  of  Physicians  of  Edinburgh  have  but  little  opportunity 
themselves  of  making  observations  of  vaccination,  as  that  practice  is  entirely  conducted 
by  surgeon  apothecaries  and  other  medical  practitioners  out  of  this  College,  and  as  the 
effects  produced  by  it  are  so  inconsiderable  and  slight  that  the  aid  of  a  physician  is  never 
required. 

the  College  know  that  in  Edinburgh  it  is  universally  approved  by  the  profession,  and 
by  the  higher  aud  middle  ranks  of  the  community,  and  that  it  has  been  much  more  gen¬ 
erally  adopted  by  the  lower  orders  of  the  people  than  even  the  inoculation  of  small-pox 
was,  and  they  believe  the  same  to  obtain  all  over  Scotland. 

With  regard  to  any  causes  which  have  hitherto  prevented  its  general  adoption,  they 
a.re  acquainted  with  none,  except  the  negligence  or  ignorance  of  parents  among  the  com¬ 
mon  people,  or  their  mistaken  ideas  of  the  impropriety  or  criminality  of  being  accessory 
to  the  production  of  any  disease  among  their  children,  or  the  difficulty  or  impossibility, 
in  some  of  our  country  districts,  of  producing  vaccine  matter,  or  a  proper  person  to  vac¬ 
cinate. 


128 


Reports  on  Vaccination  by  British  Physicians ,  1807. 


The  evidence  in  favor  of  vaccination  appeared  to  the  Royal  College  of  Physicians  of 
Edinburgh  so  strong  and  decisive  that  in  May  last  they  spontaneously  and  unanimously 
elected  Dr.  Jenner  an  Honorary  Fellow  of  their  College — a  mark  of  distinction  which 
they  rarely  confer,  and  which  they  coufiue  almost  exclusively  to  foreign  physicians  of 
the  first  eminence. 

They  did  this  with  a  view  to  publish  their  opinion  with  regard  to  vaccination,  and  in 
testimony  of  their  conviction  of  the  immense  benefits  which  have  been,  and  which  will 
in  future  be  derived  to  the  world,  from  inoculation  for  the  cow-pox,  and  as  a  mark  of 
their  sense  of  Dr.  Jenner’s  very  great  merits  and  ability  in  introducing  and  promoting 
this  invaluable  practice. 

I  have  the  honor  to  be,  gentlemen,  vour  most  obedient  humble  servant, 

,  ‘  TH.  SPENS,  C.  R.  M.  Ed.  Pr. 

To  the  Royal  College  of  Physiciaus  of  London. 


r  NO.  III. 

At  a  Special  Court  of  Assistants  of  the  Royal  College  of  Surgeons,  convened  by  order 
of  the  Master,  and  liolden  at  the  College  on  the  seventeenth  day  of  March,  1807;  Mr. 
Governor  Lucas  iu  the  chair ;  Mr.  Long,  as  Chairman  of  the  Board  of  Curators,  re¬ 
ported:  That  the  Board  are  now  ready  to  deliver  their  report  on  the  subject  of  vaccina¬ 
tion. 

It  was  then  moved,  seconded,  and  resolved,  that  a  report  from  the  Board  of  Curators, 
on  the  subject  of  vaccinatiou,  which  was  referred  to  their  consideratiou  by  the  Court  of 
Assistants,  on  the  twenty-first  day  of  November  last,  be  received. 

Mr.  Long  then  delivered  to  Mr.  Governor  Lucas  (presiding  iu  the  absence  of  the  Mas¬ 
ter)  a  report  from  the  Board  of  Curators. 

It  was  then  moved,  seconded,  and  resolved,  that  the  report  delivered  by  Mr.  Long  be 
read;  and  it  was  read  accordingly,  as  follows  : 

TO  THE  COURT  OF  ASSISTANTS  OF  THE  ROYAL  COLLEGE  OF  SURGEONS  IN 

LONDON : 

The  Report  of  the  Board  of  Curators,  on  the  subject  of  Vaccination,  referred  to  them  by 
the  Court,  on  the  twenty-first  day  of  November,  1806;  made  to  the  Court  on  the 
seventeenth  of  March,  1807. 

The  Court  of  Assistants  having  received  a  letter  from  the  Royal  College  of  Physicians 
of  London,  addressed  to  this  College,  statiug,  that  His  Majesty  had  been  graciously 
pleased,  in  compliance  with  an  address  from  the  Honorable  House  of  Commons,  to  direct 
his  Royal  College  of  Physicians  of  Londou  to  inquire  into  the  state  of  vaccination  in 
the  United  Kingdom,  to  report  their  observations  and  opinion  upon  that  practice,  upon 
the  evidence  adduced  in  its  support,  and  npou  the  causes  which  "have  hitherto  retarded 
its  general  adoption;  that  the  college  was  then  engaged  in  the  investigation  of  the  several 
propositions  thus  referred  to  them,  and  requesting  the  college  to  co-operate  and  com¬ 
municate  with  them,  in  order  that  the  report  thereupon  might  be  made  as  complete  as 
possible. 

And  having,  on  the  twenty-first  day  of  November  last,  referred  such  letter  to  the  con¬ 
sideration  of  the  Board  of  Curators,  with  authority  to  take  such  steps  respecting  the 
contents  thereof  as  they  should  judge  proper,  and  report  their  proceedings  thereon,  from 
time  to  time,  to  the  Court ;  the  Board  proceeded  with  all  possible  dispatch  to  the  con¬ 
sideration  of  the  subject. 

The  Board  being  of  the  opinion  that  it  would  be  proper  to  address  circulars  to  mem¬ 
bers  of  the  College,  with  a  view  of  collecting  evidence,  they  submitted  to  the  considera¬ 
tion  of  the  Court,  holden  ou  the  fifteenth  day  of  December  last,  the  drafts  of  such  letter 
as  appeared  to  them  best  calculated  to  answer  that  end  ;  and  the  same  having  been  ap¬ 
proved  by  the  Court,  they  caused  copies  thereof  to  be  sent  to  all  the  members  of  the 
College,  in  the  United  Kingdom,  whose  residence  could  be  ascertained,  iu  the  following 
form,  viz : 

“ Sir — The  Royal  College  of  Surgeons  being  desirous  to  co-operate  with  the  Royal  Col¬ 
lege  of  Physicians  of  London,  in  obtaining  information  respecting  vaccination,  submit 
to  you  the  following  questions,  to  which  the  favor  of  your  answer  is  requested. 

“By  order  of  the  Court  of  Assistants,  OKEY  BELFOUR,  Secretary. 

u  Lincoln’s  Inn  Fields,  December  15,  1806. 

“  QUESTIONS. 

“ First — How  many  persons  have  you  vaccinated  ? 

“< Second — Have  any  of  your  patients  had  the  small-pox  after  vaccination?  In  the 
case  of  every  such  occurrence,  at  what  period  was  the  vaccine  matter  taken  from  the 
vesicle  ?  How  was  it  preserved  ?  How  long  before  it  was  inserted  ?  What  was  the  ap- 


Reports  on  Vaccination  by  British  Physicians ,  1807. 


129 


pearance  of  the  inflammation  ?  And  what  the  interval  between  vaccination,  and  vario¬ 
lous  eruption  ? 

“ Third — Have  any  bad  effects  occurred  in  your  experience  in  consequence  of  vaccina¬ 
tion  ?  And,  if  so,  what  were  they  ? 

“ Fourth — Is  the  practice  of  vaccination  increasing  or  decreasing  in  your  neighbor¬ 
hood;  if  decreasing,  to  what  cause  do  you  impute  it? 


To  such  letters  the  Board  have  received  426  answers;  and  the  following  are  the  results 
of  their  investigation  : 

The  number  of  persons,  stated  in  such  letters  to  have  been  vaccinated,  is  164,3^1. 

The  number  of  cases  in  which  small-pox  had  followed  vaccination  is  fifty -.six. 

The  Board  thinks  it  proper  to  remark,  under  this  head,  that  in  the  enumeration  of 
cases  in  which  small-pox  has  succeeded  vaccination,  they  have  included  none  but  those 
in  which  the  subject  was  vaccinated  by  the  surgeon  reporting  the  facts. 

The  bad  consequences  which  have  arisen  from  vaccination  are,  eruptions  of  the  skin  in 
sixty-six  cases,  and  inflammation  of  the  arm  in  twenty-four  instances,  of  which  three 
proved  fatal. 

Vaccination,  in  the  greater  number  of  counties  from  which  reports  have  been  received, 
appears  to  be  increasing  ;  it  may  be  proper,  however,  to  remark,  that,  in  the  metropolis, 
it  is  on  the  decrease. 

The  principal  reasons  assigned  for  decrease  are  :  Imperfect  vaccination  ;  instances  of 
small-pox  after  vaccination  ;  supposed  bad  consequences;  publications  against  the  prac¬ 
tice  ;  popular  prejudices. 

And  such  report  having  been  considered,  it  was  moved,  seconded,  and  resolved,  that 
the  report  now  read  be  adopted  by  this  Court  as  the  answer  of  the  Court  to  the  letter  of 
the  Royal  College  of  Physicians,  of  the  twenty-third  of  October  last,  on  the  subject  of 
vaccination. 

Itesolved,  That  a  copy  of  these  minutes  and  resolutions,  signed  by  Mr.  Governor  Lucas 
(presiding  at  this  Court  in  the  absence  of  the  Master),  be  transmitted  by  the  Secretary 
to  the  Register  of  the  Royal  College  of  Physicians.  [Signed]  WM.  LUCAS. 


NO.  IV. 

Edinburgh,  March  3,  1807. 

Sir — I  mentioned  in  my  former  letter  that  I  would  take  the  earliest  opportunity  of  lay¬ 
ing  before  the  Royal  College  of  Surgeons  of  Edinburgh  the  communication  with  which 
the  Royal  College  of  Physicians  of  London  had  honored  them,  on  the  twenty-third  of 
October  last. 

I  am  now  directed  by  the  Royal  College  to  send  the  following  answer  on  that  import¬ 
ant  subject: 

The  practice  of  vaccine  inoculation,  both  in  private  and  at  the  Vaccine  Institution, 
established  here  in  1801,  is  increasing  so  rapidly  that  for  two  or  three  years  past  the 
small-pox  has  been  reckoned  rather  a  rare  occurrence,  even  amongst  the  lower  order  of 
the  inhabitunts  of  this  city,  unless  in  some  particular  quarters,  about  twelve  months 
ago  ;  and,  among  the  higher  ranks  of  the  inhabitants,  the  disease  is  unknown. 

The  members  of  the  Royal  College  of  Surgeons  have  much  pleasure  in  reporting, 
That,  as  far  as  their  experience  goes,  they  have  no  doubt  of  the  permanent  security 
against  the  small-pox  which  is  produced  by  the  constiiutional  affection  of  the  cow-pox  ; 
and  that  such  has  hitherto  been  their  success  in  vaccination,  as  also  to  gain  for  it  the 
confidence  of  the  public,  insomuch  that  they  have  not  been  required,  for  some  years 
past,  to  inoculate  any  person  with  small-pox  who  bad  not  previously  undergone  the  in¬ 
oculation  with  the  cow-pox. 

The  members  of  the  Royal  College  have  met  with  no  occurrence  in  their  practice  of 
cow-pox  inoculation  which  could  operate  in  their  minds  to  its  disadvantage,  and  they 
beg  leave  particularly  to  notice  that  they  have  seen  no  instance  of  obstinate  eruptions, 
or  of  new  and  dangerous  diseases,  which  they  could  attribute  to  the  introduction  among 
mankind  of  this  mild  preventive  of  the  small-pox.  The  Royal  College  of  Surgeons 
know  of  no  causes  which  have  hitherto  retarded  the  adoption  of  vaccine  inoculation 
here  ;  on  the  contrary,  the  practice  has  become  general  within  this  city;  and  from  many 
thousand  packets  of  vaccine  matter  having  been  sent  by  the  members  of  the  Royal  Col¬ 
lege,  and  the  Vaccine  Institution  here,  to  all  parts  of  the  country,  the  Royal  College 
have  reason  to  believe  that  the  practice  has  been  as  generally  adopted  throughout  this 
part  of  the  United  Kingdom  as  could  have  been  expected  from  proper  medical  assistance, 
and  other  circumstances  of  that  nature. 

I  have  the  honor  to  be,  Sir,  your  obedient  servant, 

WM.  EARQUIIARSON, 

President  of  the  Royal  College  and  Incorporation  of  Surgeons  of  Edinburgh. 


130 


Reports  on  Vaccination  by  British  Physicians,  1807. 


NO.  V. 

ROYAL  COLLEGE  OF  SURGEONS  IN  IRELAND,  ? 

Dublin,  February  4,  1807.  $ 

Sir — I  am  directed  to  transmit  to  you  the  enclosed  report  of  a  committee  of  the  Col¬ 
lege  of  Surgeons  in  Ireland,  to  whom  was  referred  a  letter  from  the  Royal  College  of 
Physicians  in  London,  relative  to  the  present  state  of  vaccination  in  this  pare  of  the 
United  Kingdom  ;  and  to  state,  that  the  College  of  Surgeons  will  be  highly  gratified  by 
more  frequent  opportunities  of  corresponding  with  the  English  College  of  Physicians  on 
any  subject  which  may  conduce  to  the  advancement  of  science  and  the  welfare  of  the 
public. 

I  have  the  honor  to  be,  Sir,  your  most  obedient  humble  servant, 

JAMES  HENTHORN,  Secretary, 


At  a  meeting  of  the  Royal  College  of  Surgeons  in  Ireland,  holden  at  their  Theatre,  on 
Tuesday,  the  thirteenth  day  of  January,  1807 ;  Francis  M’Evoy,  Esq.,  President ;  Mr. 
Johnson  reported  from  the  committee,  to  whom  was  referred  a  letter  from  the  College 
of  Physicians,  London,  relative  to  the  present  state  of  vaccination  in  the  United  King¬ 
dom,  etc.  ;  that  they  met  and  came  to  the  following  resolutions 

That  it  appears  to  this  committee,  That  inoculation  with  vaccine  infection  is  now  very 
generally  adopted  by  the  surgical  practitioners  in  this  part  of  the  Kingdom  as  a  preven¬ 
tive  for  small-pox. 

That  it  appears  to  this  committee,  That  from  the  twenty-fifth  day  of  March,  1800,  to 
the  twenty-fifth  of  November,  1806,  11,504  persons  have  been  inoculated  with  vaccine  in¬ 
fection  at  the  dispensary  for  infant  poor,  and  2,831  at  the  cow-pox  institution,  making  a 
total  of  14,335,  exclusive  of  the  number  inoculated  at  hospitals  and  other  places,  where 
no  registry  is  made  and  preserved. 

That  it  is  the  opinion  of  the  committee,  That  the  cow-pox  has  been  found  to  be  a  mild 
disease,  and  rarely  attended  with  danger,  or  any  alarming  symptom,  and  that  the  few 
cases  of  small-pox  which  have  occurred  in  this  country,  after  supposed  vaccination,  have 
been  satisfactorily  proved  to  have  arisen  from  accidental  circumstances,  and  cannot  be 
attributed  to  the  want  of  efficacy  in  the  genuine  vaccine  infection  as  a  preventive  of 
small-pox. 

That  it  is  the  opinion  of  this  committee,  that  the  causes  which  have  hitherto  retarded 
the  more  general  adoption  of  vaccination  in  Ireland,  have,  in  a  great  measure,  proceeded 
from  the  prejudices  of  the  lower  classes  of  the  people,  and  the  interest  of  some  irregular 
practitioners. 

To  which  report  the  College  agrees.* 

[Extract  from  the  Minutes  ] 

JAMES  HENTHORN,  Secretary. 


*In  addition  to  the  above  highly  satisfactory  document,  it  may  be  proper  to  state,  that  the  English  House 
of  Commons  have  just  voted  £20,000  additional  to  Dr.  Jenner,  'as  the  discoverer  of  vaccination. 


Causes  of  Failures  in  Vaccination. 


131 


THE  OCCASIONAL  OCCURRENCE  OF  SMALL  POX  AND  MODI¬ 


FIED  SMALL  POX  (VARIOLOID),  AFTER  VACCINATION  EX, 
CITED  IN  THE  MINDS  OF  SOME  DISTRUST  AS  TO  THE  PRO¬ 


TECTIVE  POWER  OF  COW-POX  INOCULATION,  AND  LEAD 
TO  CAREFUL  INVESTIGATION  ON  THE  PART  OF  THE  AD¬ 
VOCATES  OF  VACCINATION.  THE  YEAR  1801  FORMED  AN 
ERA  IN  THE  HISTORY  OF  VARIOLiE  VACCINAL  I)R.  JEN- 
NER  REFERRED  THE  REPUTED  FAILURES  OF  VACCINA¬ 
TION  TO  SEVERAL  CAUSES, AS:  IGNORANCE  AND  CARE¬ 
LESSNESS  ON  THE  PART  OF  MANY  INOCULATORS,  WHO 
FAILED  TO  DISCRIMINATE  WITH  DUE  ACCURACY  BE¬ 


TWEEN  THE  PERFECT  AND  IMPERFECT  PUSTULE  ;  SUCH 
MODIFICATION  OF  THE  VACCINE  PUSTULE  DURING  ITS 
PROGRESS  AS  TO  DEPRIVE  IT  OF  ITS  EFFICACY;  THE 
POWER  OF  THE  HERPETIC  AND  OTHER  IRRITABLE  ERUP¬ 
TIONS  TO  RENDER  THE  VARIOLOUS  AS  WELL  AS  THE 
VACCINE  INOCULATION  IMPERFECT. 


The  year  1801  formed  an  era  in  the  history  of  variolse  vaccime,  for  at 
this  time  the  reports  of  failures  in  vaccination  had  begun  to  multiply,  and 
the  fears  of  some  of  its  supporters  had  been  thereby  excited  to  an  immod¬ 
erate  degree.  Whilst  Jenner  deplored  the  ignorance  that  gave  occasion  to 
such  rumors,  he  felt  no  anxiety  concerning  his  great  and  fundamental  posi¬ 
tion.  Writing  to  Lord  Berkeley  on  this  subject,  he  said  :  “I  expect  that 
cases  of  this  kind  will  flow  in  upon  me  in  no  inconsiderable  number;  and 
for  this  plain  reason — a  great  number,  perhaps — the  majority  of  those  who 
inoculate  are  not  sufficiently  acquainted  with  the  nature  of  the  disease  to 
enable  them  to  discriminate  with  due  accuracy  between  the  perfect  and  im¬ 
perfect  pustule.  This  is  a  lesson  not  difficult  to  learn,  but  unless  it  is 
learned,  to  inoculate  the  cow-pox  is  folly  and  presumption.” 

To  another  correspondent  he  said . 

“  Wlnit  I  have  said  on  this  vaccine  subject  is  true.  If  properly  conducted,  it  secures  the  con¬ 
stitution  "as  much  as  variolous  inoculation  possibly  can.  It  is  the  small -pox  in  a  purer  form 
than  that  which  has  been  current  among  us  for  twelve  centuries  past.” 

Mr.  Goldson,  of  Portsea,  actuated  by  prejudice,  joined  Dr.  Moseley  in  his 
conjectural  arguments  against  vaccination.  In  1804  the  assertion  was  made 
that  the  cow-pox  afforded  only  a  temporary  security.  Had  it- been  correct, 
it  would  have  deprived  the  discovery  of  Dr.  Jenner  of  nearly  all  its  value. 
This  assertion  was  very  easily  made,  and  in  the  infancy  of  the  practice, 
could  not  be  well  disproved.  To  these  circumstances  it  was  owing  that  the 
crude  and  unsupported  statements  of  Mr.  Goldson  acquired  any  influence. 
Dr.  Jenner  himself,  from  the  commencement,  perceived  that  in  his  cases  of 
failure,  cow-pox  had  never  properly  taken  place. 

The.  real  merits  of  the  question  were  also  detected  by  Mr.  Dunning, 
one  of  the  first  British  surgeons  who  stood  forward  to  recommend  vaccina¬ 
tion,  soon  after  the  practice  was  promulgated,  and  to  the  day  of  his  death 
upheld  the  accuracy  and  justness  of  Jenner’s  views.  His  little  tract,  pub¬ 
lished  about  this  time,  under  the  title  of  “A  Short  Detail  of  Some  Circum¬ 
stances  Connected  with  Vaccine  Inoculation,”  etc.,  contains  some  of  the 
soundest  opinions  with  regard  to  the  nature  of  variolse  and  variolce  vac- 


132 


Causes  of  Failures  in  Vaccination. 


cinge  that  have  ever  appeared.  It  was  by  studying  small-pox  that  lie  be¬ 
came  thoroughly  acquainted  both  with  the  benefits  conferred  by  vaccination 
'and  those  principles  that  ought  to  direct  the  practice. 

Some  of  the  points  which  are  even  at  the  present  time  matters  of  dis¬ 
cussion,  were  fully  explained  at  this  early  period  of  vaccination.  It  was 
then  clearly  ascertained,  that  there  were  deviations  from  the  usual  course 
of  small  pox,  which  was  quite  as  common,  and  infinitely  more  disastrous, 
than  those  which  took  i>lace  in  vaccination.  These  deviations  regarded 
two  apparently  different  states  of  the  constitution.  In  the  one,  the  sus¬ 
ceptibility  of  small-pox  was  not  taken  away  by  previous  infection  ;  while 
on  the  other  hand,  some  constitutions  seem  to  be  unsusceptible  of  small¬ 
pox  infection  altogether.  It  was  found,  that  similar  occurrences  took 
place  in  the  practice  of  vaccination  ;  but  as  the  security  which  the  latter 
afforded  was  more  likely  to  be  interfered  with  by  slight  cases  than  the 
former,  it  became  absolutely  necessary  that  good  care  should  be  shown  in 
watching  the  progress  and  character  of  the  pustule. 

Dr.  Jenner  had  from  the  beginning  felt  the  propriety  of  this  watchful¬ 
ness;  and  had  distinctly  announced  that  it  was  possible  to  propagate 
an  affection  by  inoculation  conveying  different  degrees  of  security,  ac¬ 
cording  as  that  affection  approached  to,  or  receded  from,  the  full  and  per¬ 
fect  standard.  He  also  clearly  stated,  that  the  course  of  the  vaccine  pus¬ 
tules  might  be  so  modified  as  to  deprive  it  of  its  efficacy ;  that  inoculation 
from  such  a  source  might  communicate  an  inefficient  protection,  and 
that  all  who  were  thus  vaccinated  were  more  or  less  liable  to  sub¬ 
sequent  small-pox.  His  directions  for  obviating  occurrences  of  this  kind 
regarded,  first,  the  character  of  the  pustule  itself,  the  time  and  quality  of 
the  lymph  taken  for  inoculation,  and  all  other  circumstances  that  might 
go  to  affect  the  completed  progress  of  the  disorder.  He  attached  great 
importance  to  this  last  point;  and  in  the  course  of  1804  published  his 
tract  “  On  the  Varieties  and  Modifications  of  the  Vaccine  Pustule,  Occa¬ 
sioned  by  an  Herpetic  State  of  the  Skin.” 

The  following  sentence  in  the  introduction  is  worthy  of  note: 

“  I  shall  here  just  observe,  that  the  most  ample  testimonies  now  lie  before  me,  sup¬ 
porting  my  opinion  that  the  herpetic,  and  some  other  irritive  eruptions,  are  capable  of 
rendering  variolous  inoculation  imperfect,  as  well  as  the  vaccine.” 

Besides  the  instructions  which  Dr.  Jenner  himself  had  published,  for 
the  purpose  ot  securing  perfection  in  the  vaccine  process,  Mr.  Dunning 
has  themeritof  establishing  a  canon,  namely,  that  one  pustule  at  least  should 
remain  undisturbed.  Dr.  Jenner  candidly  admitted  the  propriety  of  this 
rule  of  Mr.  Dunning. 

In  a  letter  to  Dr.  Willan,  dated  February  23,  1800,  Dr.  Jenner  says  : 

“It  strikes  me  that  the  constitution  loses  its  susceptibility  of  small-pox  contagion,  and 
the  capability  of  producing  the  disease  in  its  ordinary  state,  in  proportion  to  the  degree 
of  perfection  which  the  vaccine  vesicle  has  put  on  in  its  progress;  and  that  the  small¬ 
pox,  if  taken  subsequently,  is  modified  accordingly;  this  opinion  was  first  published  by 
Mr.Dunning  of  Plymouth.” 

In  a  letter  to  his  friend  Mr.  Dunning,  dated  Berkeley,  December  23,  1804, 
Dr.  Jenner  thus  alludes  to  the  work  of  Goldson  : 

“You  speak  of  Ring,  and  Goldson.  Recollect  then  was  the  time  to  be  cool.  What 
came  of  vaccination — what  man  well  acquainted  with  its  nature,  or  that  of  the  small-pox, 
could  read  Goldson’s  book,  and  lay  it  down  cooly?  Ring,  the  moment  he  read  it, ‘and 
that,  indeed,  which  was  infinitely  worse  than  the  book  itself,  the  murderous  harbinger— 
the  advertisement,  instantly  charged  his  blunderbuss,  and  fired  in  the  face  of  the  author. 
I  must  freely  confess,  I  do  not  feel  so  cooly  about  Mr.  Goldson  as  you  do.  His  book  has 
sent  many  a  victim  to  a  premature  grave;  and  would  have  sent  many  more,  but  for  the 
humanity  and  zeal  of  yourself  and  others  who  stepped  forward  to  counteract  its  dread- 


133 


L 

_ * 

Causes  of  Failures  in  Vaccination. 


ful  tendancy.  Had  Goldson  Lilt  written  to  me,  stating  those  occurances  in  his  prac¬ 
tice  which  appeared  extraordinary,  I  should  with  the  greatest  pleasure  have  told  him 
where  the  mistake  lay  ;  and  made  him  a  good  vaccinfst.  *  *  * 

“But  to  return.  There  may  be  peculiarities  of  constitution  favorable  to  this  phe¬ 
nomenon.  My  opinion  still  is,  that  the  grand  interference  is  from  the  agency  of  this 
herpes,  in  some  form  or  other ;  for  I  have  discovered  that  it  is  a  very  Proteus,  assuming 
as  it  thinks  fit,  the  character  of  the  greater  part  of  the  irritative  eruptions  that  assail  us. 
I  shall  have  much  to  say  ou  this  disease  one  of  these  days.'’’ 

“The  security  given  to  the  constitution  by  vaccine  inoculation,  is  exactly  equal  to  that 
given  by  the  variolous.  As  failures  in  the  latter  are  constantly  presenting  themselves, 
nearly  from  its  commencement  to  the  present  time,  we  must  expect  to  find  them  in  the 
former  also.  In  my  opinion,  in  either  case,  they  occur  from  the  same  causes;  one  might 
name  for  example,  among  others,  some  peculiarities  of  constitution  which  prevent  the 
virus  from  acting  properly,  even  when  properly  applied  ;  from  inattention  or  want  of 
due  knowledge  in  not  being  able  to  discriminate  between  the  correct  and  incorrect 
pustule.”  *  *  * 

“Wonderful  as  it  is,  yet  there  are  abundant  facts  to  prove,  that  the  insertion  of 
variolous  matter  info  the  skin  lias  produced  a  virus  fit  for  the  purpose  of  continuing  the 
inoculation  ;  and  yet  the  person  who  has  borne  it,  and  on  whose  skin  it  was  generated, 
has  subsequently  been  infected  with  the  small-pox,  on  exposure  to  its  influence.  Just  so 
with  the  vaccine.” 

“  Vaccine  inoculation  has  certainly  unveiled  many  of  the  mysterious  facts  attendant 
upon  the  small-pox  and  its  inoculation.  How  often  have  we  seen  (apparently)  the  full 
effects  of  the  arm  from  the  insertion  of  variolous  matter,  indisposition  and  even  erup¬ 
tions  following  it,  and  its  termination  in  an  extensive  and  deep  cicatrix;  and  yet,  on 
exposure,  the  person  who  underwent  this,  has  caught  the  small-pox.” 

In  one  ot  his  journals,  Dr.  Jenner  has  left  the  following-  notes  upon  the 
same  subject : 

“  The  origin  of  the  small-pox  is  the  same  as  that  of  the  cow-pox;  and  as  the  latter 
was  probably  coeval  with  the  brute  creation,  the  former  was  only  a  variety  springing 
from  it.” 

“There  are  certainly  more  forms  than  one  (without  considering  the  common  variation 
between  the  confluent  aud  distinct)  in  which  the  small-pox  appears  in  what  is  called  the 
natural  way.” 

“  It  will  be  iuquired  (if  the  foregoing  reasoning  be  a  priori  correct)°in  which  way  can 
the  action  of  cow-pox  (or  the  equine  pock)  in  preventing  subsequently  small-pox  be  re¬ 
concilable  with  the  established  laws  of  the  animal  economy  ?  My  reply  is,  for  the  rea¬ 
sons  which  1  have  stated  on  the  basis  of  facts,  that  they  were  not  bona  fide  dissimilar  in 
their  nature;  but,  on  the  contrary,  identical.  On  this  ground  I  gave  my  first  book  of 
‘An  Inquiry  into  the  Causes  and  Effects  of  the  Variolce  Yaceince’ — a  circumstance  which 
has  since  been  regarded  by  many  as  the  happy  foresight  of  a  connection  which  was  de¬ 
stined  by  further  evidence  to  become  more  warranted.” — The  Life  of  Edward  Jenner ,  M. 
1).,  LL.  D.,  F.  IL  S.}  Etc.,  by  John  Baron,  AT.  D.,  E,  B.  S.,  vol.  2,  pp.  12-31. 


134 


Epidemic  Small-Fox  of  1818. 


THE  EPIDEMIC  SMALLPOX  OF  1818— THE  PREVALENCE  OF 
SMALL  POX  IX  GREAT  BRITAIN  AND  ON  THE  CONTINENT 
DEVELOPED  INCREASED  HOSTILITY  TO  THE  PRACTICE 
OF  VACCINATION— DR.  JENNER  BELIEVED  IMPERFECT 
VACCINATION,  OR  SOME  CAUSE  WHICH  INTERFERED 
WITH  THE  REGULAR  AND  COMPLETE  PROGRESS  OF  THAT 
INFECTION  TO  BE  THE  MAIN  SOURCE  OF  SUCH  EVILS— 
SOME  OF  THE  DIFFICULTIES  WHICH  PERPLEXED  THE 


SUBJECT  IN  EDINBURGH;  ALSO,  FROM  A  DEGREE  OF 
UNCERTAINTY  THAT  PREVAILED  REGARDING  THE  CHAR¬ 
ACTER  OF  THE  EPIDEMIC  AT  ITS  FIRST  APPEARANCE, 
DR.  IIENNEN  AND  OTHERS  WERE  INCLINED  TO  THINK 


THAT  THE  DISEASE  WA«S  VARICELLA  OR  CIIICKEN-POX 


OF  A  MALIGNANT  CHARACTER— ABANDONMENT  OF  THIS 


VIEW— INVESTIGATIONS  OF  DR.  ALEXANDER  MONRO,  OF 
EDINBURGH,  OF  THE  VARIETIES  OF  SMALL  POX  AND  THE 
EFFICACY  OF  COW-POX  INOCULATION— HIS  EXPLANA¬ 
TION  OF  THE  CAUSES  OF  THE  PREVALENCE  OF  SMALL¬ 
POX  IN  1817  AND  1818. 

In  the  course  of  the  year  1818  a  violent  epidemic  of  small  pox  prevailed 
in  many  parts  of  Great  Britain,  as  well  as  on  the  continent;  an  increased 
hostility  was  evinced  to  the  practice  of  vaccination  ;  and  doubts  of  its  effi¬ 
cacy,  which  had  been  artfully  excited,  soon  propagated  to  other  parts  of  the 
world.  The  small-pox  was  unusually  fatal  and  malignant  in  Edinburgh 
and  several  other  places  in  Scotland ;  it  killed  a  very  large  proportion  of 
those  whom  it  attacked  in  the  natural  way;  and  it  likewise  spread  to  many 
who  had  previously  had  small-pox,  as  well  as  cow-pox. 

Dr.  Jenner  believed  improper  vaccination,  or  some  cause  which  interfered 
with  the  regular  and  complete  progress  of  that  affection,  to  be  the  main 
source  of  such  evils.  He  admitted  that  small  pox  might  succeed  perfect 
vaccination,  just  as  small  pox  does  succeed  small  pox;  but  the  great  num¬ 
ber  of  failures  which  were  reported  to  have  occurred,  he  thought,  could 
only  be  accounted  for  by  supposing  that  some  circumstances  interrupted 
the  proper  influence  of  vaccination  in  the  system.  One  of  them  he  con¬ 
ceived  to  be  the  existence  of  cutaneous  disease. 

There  can  be  no  doubt  of  the  truth  of  Jenner’s  main  proposition,  pub¬ 
lished  in  his  circular  letter,  namely,  that  when  vaccine  failures  were  very 
frequent,  there  must  have  been  some  imperfections  either  in  the  virus  or  in 
the  progress  of  the  affection.  This  fact  is  rendered  manifest  by  the  differ¬ 
ent  degrees  of  success  which  have  attended  the  practice  of  different  indi¬ 
viduals.  After  patient  inquiry,  Dr.  John  Baron,  the  learned  and  accom¬ 
plished  author  of  the  life  of  Dr.  Jenner,  did  not  know  of  more  than  six  or 
eight  cases  of  small  pox  after  cow-pox  among  all  Dr.  Jenner’s  patients. 
This  proportion  is  probably  no  more  than  might  have  occurred  had  he  in' 
oeulated  for  the  small-pox  instead  of  the  cow-pox. 

Some  of  the  difficulties  which  perplexed  the  subject  in  Edinburgh,  arose 
from  a  degree  of  uncertainty  that  prevailed  regarding  the  character  of  the 
epidemic  at  its  first  appearance,  Dr.  Hennen  was  inclined  to  think  that 


Epidemic  Small-Pox  of  1818. 


135 


/**•■*■ - — - - - - - - - 

the  disease  was  varicella  or  chicken-pox,  of  a  malignant  character.  H«e 
was  obliged,  however,  to  abandon  this  notion.  Dr.  Thompson  went  further 
than  Dr.  Hennen ;  and  in  a  very  elaborate  work  endeavored  to  prove  that 
the  varicella,  instead  of  being  a  distinct  and  peculiar  disease,  as  had  been 
generally  supposed,  was  only  a  variety  or  modification  of  small  pox. 

Dr.  Hennen  in  his  paper  on  eruptive  diseases,  thus  expressed  his  belief 
in  the  efficacy  of  vaccination  :  “  So  perfectly  convinced  am  I  of  the  pre¬ 

venting  and  modifying  powers  of  the  vaccine  inoculation,  that  I  should 
never  hesitate  about  employing  it,  even  though  it  were  probable  that  my 
patient  had  imbibed  the  small  pox  infection.  Nor  should  I  be  deterred 
from  the  practice  by  the  idle  supposition  of  the  mpSe  that  I  was  too  late, 
or  the  learned  objection  of  the  doctor  that  the  two  diseases  could  not  co¬ 
exist;  experience  very  clearly  demonstrating ,  that  there  is  still  something  in  the 
mutual  relations  of  these  diseases  to  each  other  that  has  not  yet  been  satisfac¬ 
torily  elucidated. 

‘‘After  the  most  mature  deliberation,  I  most  explicitly  avow,  that  noth¬ 
ing  has  occurred  in  these  cases  which  has  in  the  smallest  degree  shaken 
my  opinion  of  the  great  and  pre-eminent  importance  of  the  practice  of 
vaccination ;  whether  we  view  it  as  a  preventive  of  small  pox  in  a  vast 
majority  of  cases£,  or  as  a  most  effectual  neutralizer  of  its  malignity  in  the 
comparatively  few  instances  in  which  from  some  peculiarity  of  constitu¬ 
tion,  or  some  anomaly  in  the  process  hitherto  but  fully  developed,  it  has 
failed  to  afford  this  permanent  security.” 

There  can  be  no  doubt  that  during  the  first  years  of  vaccine  inoculation 
there  had  been  great  carelessness  and  inattention  in  conducting  the 
practice.  And  in  1818,  there  were  numerous  complaints  of  the  bad  quality 
of  the  vaccine  lymph.  Dr.  Jennei*  received  hints  of  this  kind  from  Italy, 
from  America,  and  many  parts  of  England. 

The  greatly  exaggerated  statements  on  this  subject  of  the  vaccine  fail¬ 
ures,  and  the  hesitating  manner  in  which  many  respectable  physicians 
spoke  on  the  subject,  threatened  to  lead  to  a  considerable  abandonment  of 
this  practice. 

Under  these  circumstances  Sir  Gilbert  Blane  rendered  distinguished 
services  to  the  cause  of  vaccination,  by  proving  by  the  most  conclusive 
reasoning,  and  an  appeal  to  the  most  authentic  documents,  that  the 
importance  of  the  vaccine  discovery  was  not  in  the  most  essential  points  low¬ 
ered  by  the  failures  which  were  alleged  to  have  taken  place.  In  order  to 
bring  this  matter  to  the  test  of  calculation  Sir  Gilbert  Blane,  selected 
from  periods,  each  of  fifteen  years,  for  the  purpose  of  exhibiting  the  com¬ 
parative  mortality  of  small-pox.  The  last  series  comprehended  the  time  in 
which  the  vaccine  inoculation  had  been  so  far  diffused  as  to  produce  a 
notable  effect  in  the  deaths  from  this  disease.  The  result  of  the  whole 
was,  that  even  under  the  very  imperfect  practice  of  vaccinnation  which 
had  taken  place  in  London,  23,134  lives  had  been  saved  in  the  fifteen  years 
alluded  to,  that  is  from  1804  to  1818  inclusive. 


INVESTIGATIONS  OF  DR.  ALEXANDER  MONRO  ON  SMALL¬ 
POX  AND  VACCINATION. 

Dr.  Alexander  Monro,  Professor  of  Anatomy  and  Surgery  in  the  Uni¬ 
versity  of  Edinburg,  in  his  “  observations  on  the  different  kinds  of  small¬ 
pox,  and  especially  on  that  which  sometimes  follows  vaccination,”  pub¬ 
lished  in  1818,  states  in  the  introduction,  p.  24,  with  reference  to  the 
disease  in  Scotland : 


136 


Dr.  Alexander  Monro  on  Small-Pox  and  Vaccination. 


•  “  All  the  cases  of  small-pox  -which  have  lately  occurred  have  been  imputed  to  the  in¬ 
efficiency  of  the  cow-pox;  whereas  I  have  ascertained  upon  grounds  perfectly  satisfac¬ 
tory  to  myself,  that  a  few  only  have  originated  from  that  cause,  as  in  a  great  majority  of 
the  instances  of  small-pox  now  to  he  observed  among  the  lower  orders  of  society,  vac¬ 
cination  had  never  been  performed,  and  in  others  it  had  been  imperfect. 

“  It  ought  not  to  be  forgotten,  that  in  the  first  instance  at  least,  Dr,  Jenner’s  discovery 
appeared,  in  one  important  respect,  to  be  rather  incomplete;  it  did  not  furnish  the  inex¬ 
perienced  eye,  a  certain  means  of  distinguishing  whether  the  disease  be  genuine  or  not, 
and  also  whether  the  constitution  of  the  patient  had  been  actually  subjected  to  the  in¬ 
fluence  of  the  cow-pox — a  great  desideratum.  That  desideratum  was  still  required,  I 
mean  a  text,  for  distinguishing  whether  or  not  the  influence  of  the  cow-pox  has  been  constitutional 
or  only  local.  This  was  supplied  by  the  ingenuity  of  Mr.  Bryce,  who  discovered,  that  by 
re-inoculating  on  the  fifth  day  on  the  other  arm,  the  pimples  on  both  arms  follow  exactly 
the  same  course,  and  arrive  at  maturity  at  the  same  time  if  the  disorder  has  been  consti¬ 
tutional  ;  and  this  is  what  1  understand  by  perfect  vaccination . 

“  But  though  it  cannot  be  denied  that  vaccination  has  failed  to  give  perfect  security 
against  the  small-pox,  yet  in  the  cases  where  it  has  failed  to  do  so  it  has  modified  and 
mitigated  that  loathsome  and  dangerous  disorder  in  a  most  remarkable  manner,  so  that 
the  small-pox  after  cow-pox  can  scarcely  be  said  to  form  one  of  the  class  of  mortal  dis¬ 
eases.  P.  24  25. 

Dr.  Alexander  Monro  communicates  the  following  as  the  chief  causes  which  had  led  to 
the  failure  of  the  vaccine  inoculation. 

“1.  The  matter  for  inoculation  has  sometimes  been  taken  from  a  spurious  sore,  which, 
though  it  occasioned  a  vesicle,  and  excited  inflammation  in  the  inoculated  patient,  did 
not  communicate  the  genuine  disease,  or  it  has  been  taken  from  the  true  sore  at  too  late 
a  stage  of  its  progress  :  and  hence,  though  it  occasioned  aecute  inflammation,  it  did  not 
communicate  the  true  cow-pox. 

“  2.  If  the  lancet  on  which  the  matter  of  small-pox  is  present  shall  become  rusty,  the 
rust  of  the  steel  decomposes  the  poison. 

“3.  If  the  vaccine  vesicle  has  been  repeatedly  punctured  or  drained  for  two  or  three 
successive  days,  the  inoculation  generally  fails  ;  for  the  poison  which,  in  the  progress  of 
the  disease,  is  depositing  in  the  cells  of  the  vesicle,  is  thus  exhausted,  or  may  be  so  much 
diluted  as  to  be  incapable  of  producing  the  disease. 

“4.  The  matter  taken  from  the  genuine  cow-pox  vesicle  may  be  injured  by  heat,  ex¬ 
posure  to  the  air,  or  moisture. 

“5.  If  the  matter  be  taken  from  the  cow-pox  vesicle  after  the  thirteenth  day,  it  ‘  does 
not/ according  to  Willan,  ‘produce  the  genuine  cellular  vesicle,  but  is  in  some  cases 
wholly  inefficient,  while  in  others  it  suddenly  excites  a  pustule  or  ulceration  ;  in  others  a 
regular  vesicle,  and  in  others  erysipelas.’ 

‘‘6.  If  the  crusts  employed  for  cow-pox  inoculation  be  kept  in  a  high  temperature, 
or  in  a  damp  place,  they  soon  acquire,  as  Mr.  Bryce  has  well  observed,  a  peculiar  smell, 
which  marks  their  loss  of  power  to  reproduce  the  cow-pox. 

“7.  The  inoculation  for  cow-pox  does  not  take  effect  when  the  child  labors  under 
other  cutaneous  disorders,  as  measles,  scarlatina,  itch,  herpes,  tenia  capitis,  or  cruita 
lacta.” 

“Imperfect  vaccination,”  says  Dr.  Willan,  “  is  not  characterized  by  any  uniform  sign 
or  criterion,  but  exhibits  in  different  cases  very  different  appearances,  as  pustules,  ulcer¬ 
ations,  or  vesicles  of  an  irregular  form.  The  vaccine  pustule  is  conoidal;it  increases 
rapidly  from  the  second  to  the  fifth  or  sixth  day,  being  raised  on  a  hard,  inflamed  base, 
with  diffuse  redness,  extending  beyond  it  on  the  skin.  It  is  usually  broken  before  the 
end  of  the  sixth  day,  and  is  soon  after  succeeded  by  an  irregular  yellowish-brown  scab. 
The  redness  disappears  within  a  day  or  two,  and  the  tumor  gradually  subsides.” 

According  to  Dr.  .Tenner,  “  the  commencement  is  marked  by  a  troublesome  itching,  and 
it  throws  out  a  premature  efflorescence,  sometimes  extensive,  but  seldom  circumscribed, 
or  of  so  vivid  a  tint  as  that  which  surrounds  the  pustule  (vesicle)  completely  organized, 
and  (which  is  now  characteristic  of  Its  degeneracy  than  the  other  symptoms)  it  appears 
more  like  a  common  festering  produced  by  a  thorn,  or  any  other  small  extraneous  body 
sticking  in  the  skin,  than  a  pustule  (visicle)  excited  by  any  vaccine  virus.  It  is  gener¬ 
ally  of  a  straw  color,  ond  when  punctured,  instead  of  the  colorless  transparent  fluid  of 
the  perfect  vesicle,  its  contents  are  found  to  be  opaque.” 

According  to  Dr.  Alexander  Monro,  “when  the  vesicles  are  irregular  or  imperfect, 
there  is  commonly  premature  itching,  which  is  so  great  as  to  promote  scratching,  in¬ 
flammation  and  the  formation  of  matter. 

“  The  progress  of  the  vesicle  is  too  rapid,  its  texture  is  soft,  and  it  is  apt  to  be  broken  ; 
the  border  is  not  well  defined,  the  middle  is  raised,  and  the  contents  discolored  or  puru¬ 
lent,  and  it  is  encircled  by  a  premature  efflorescence  of  a  dirty  purple  hue,  and  the  scab 
is  of  an  ambre  color. 

_  “  It  has  been  mentioned  by  Messrs.  Dawson  and  Kate  (Transactions  of  College  of  Phy¬ 
sicians,  vol.  3)  that  the  part  into  which  the  variolous  poison  has  been  inserted,  inflames, 


Dr.  Alexander  Monro  on  Small-Pox  and  Vaccination. 


137 


and  a  pustule  is  produced,  which  is  tilled  by  an  active  variolous  poison,  capable  of  excit¬ 
ing  the  disease  in  others,  without  the  person  himself  being  constitutionally  affected  by 
small-pox,  or  being  by  this  pustule  on  h  is  body  rendered  unsusceptible  of  variolous  conta¬ 
gion  at  a  future  period  of  his  life.  The  same  has  been  observed  by  several  others,  and 
this  may  undoubtedly  happen  in  cow-pox  as  Avell  as  in  the  small-pox  inoculation,  and 
thus  form  a  fruitful  somce  of  disappointment  in  conducting  vaccination. 

“  All  of  these  difficulties  have  been  removed  by  the  ingenuity  of  Mr.  Bryce,  who  has 
supplied  us  with  a  certain  test  for  determining  these  important  points,  which  consist  in 
reinoculating  the  child  on  the  other  arm  on  the  fifth  day  after  the  first  inoculation.  If 
the  constitution  has  been  affected,  the  vesicles  on  both  arms  arrive  equally  soon  at  matu¬ 
rity,  and  also  fade  together.  The  arguments  advanced  in  favor  of  Mr.  Bryce’s  test  are 
founded  on  the  most  vigorous  investigation,  and  in  my  mind  amount  to  a  complete  dem¬ 
onstration  of  its  importance,  and  have  been  confirmed  both  by  the  testimony  of  experi¬ 
ence  and  of  public  opinion.  My  father,  in  his  lectures,  used  always  to  express  his  utmost 
confidence  in  Mr.  Bryee’3  test  as  a  mark  that  the  constitution  has  been  affected,  and  also 
his  opinion  that  its  ingenious  author  merited  a  public  reward,  he  considered  Dr.  Jen- 
ner’s  discovery  to  be  incomplete.” — Observations  on  the  Different  Kinds  of  Small-pox,  and 
especially  on  that  which  sometimes  follows  vaccination  ;  illustrated  by  a.  number  of 
cases.  By  Alexander  Monro,  M.  D.,  F.  R.  S.  E.,  Professor  of  Anatomy  and  Surgery  in 
the  University  of  Edinburgh,  Fellow  of  the  Royal  College  of  Physicians,  Etc.,  Edin¬ 
burgh,  1818;  pp.  108-113. 

The  following  account  of  the  Test  of  Mr.  Bryce,  for  Successful  Vaccin¬ 
ation,  is  given  in  the  author’s  own  words,  and  it  is  worthy  of  consideration, 
not  merely  on  theoretical  grounds  in  connection  with  the  history  of  cow- 
pox  inoculation,  but  more  especially  at  the  present  time,  when  vaccination 
is  too  often  performed  in  a  careless  manner,  or  when  hostility  to  the  meas¬ 
ure  appears  to  have  received  a  new  impetus. 

MR.  BRYCE’S  TEST. 

“1  am  thoroughly  convinced  that  some  clear  and  well  defined  mark  of  a  constitutional 
affection  iu  cow-pox,  different  from  what  has  hitherto  been  observed  by  those  who  have 
written  on  the  subject,  is  still  to  be  regarded  as  the  grand  desideratum  in  conducting 
this  new  inoculation  ;  for,  until  this  be  established,  our  judgment  of  the  efficacy  of  the 
cow-pox  inoculation  in  preventing  small-pox,  must  often  be  formed  with  doubt  and  anx¬ 
iety,  and  too  frequently  prove  ultimately  erroneous.  The  truth  of  these  remarks  will 
be  best  known  to  those  mostly  conversant  with  the  cow-pox  inoculation,  and  who  are 
accustomed  to  observe  the  great  variety  of  appearances  which  the  affection  at  the  part 
inoculated  often  assumes. 

“  For  some  time  after  the  introduction  of  the  cow-pox  inoculation  into  medical  prac¬ 
tice,  many  cases  were  related  in  which  an  eruption  of  pustules,  more  or  less  numerous, 
was  said  to  take  place,  similar  to  what  happens  in  small-pox.  While  these  reports  were 
propagated,  and  certified  by  men  who  seemed  worthy  of  credit,  even  although  no  in¬ 
stance  of  the  period  had  come  under  my  own  observation,  I  entertained  hopes  of  so  con¬ 
ducting  the  new  inoculation  in  every  case  as  to  obtain  a.  certain  and  well-defined  mark 
of  a  constitutional  affection;  for,  if  an  eruption  of  pustules  belonged  to  cow-pox  in  any 
case,  as  a  consequence  of  the  peculiar  fever  or  constitutional  ailment  thereby  induced,  J 
thought  that  one  or  two  pustules  might  be  made  to  appear  in  every  case.  It  is  well 
known  that  by  irritating  any  part  of  the  skin,  by  the  application  of  heat,  or  a  stimulat¬ 
ing  plaster,  or  various  other  substances,  we  can  produce  a  greater  number  of  pustules  of 
small-pox  upon  that  particular  part  than  would  otherwise  have  appeared;  and  judging 
from  analogy,  I  expected  that  the  same  theory  in  ght  have  been  affected  on  cow-pox. 
Such  lrials  I  have  made;  and  although  they  were  conducted  with  as  much  anxiety  and 
care  to  produce  pustules  as  other  persons  seem  to  have  taken  to  avoid  producing  them, 
yet  they  have  constantly  failed  ;  nay,  these  trials  have  now  been  made  under  such  a  va¬ 
riety  of  circumstances  without  effect  as  to  confirm  me  in  the  opinion,  that  an  eruption 
of  pustules,  as  a  consequence  of  a  constitutional  affection,  does  not  belong  to  the  cow-pox. 

Foiled  in  my  attempts  so  to  conduct  the  inoculation  of  cow-pox  as  to  produce  pus¬ 
tules, -I  recollected  some  experiments  which  had  been  made  with  regard  to  the  inocu¬ 
lation  of  small-pox.  It  wjTs  found  that  if  the  same  person  was  inoculated  every  day 
until  the  fever  induced  by  the  first  inoculation  supervened,  all  the  other  punctures 
quickly  advanced  in  their  progress ;  and  that,  in  the  course  of  a  day  from  the  time  the 
fever  or  general  affection  began,  even  that  puncture  which  had  been  last  made,  perhaps 
only  twenty-four  hours  before,  and  from  which  the  fever  had  arisen. 

“  In  this  case,  it  appears  to  me  evident,  and  I  think  must  be  admitted  by  every  per¬ 
son,  that  even  had  no  other  pustules  appeared  on  the  body  than  those  occasioned  bv  the 


138 


Dr.  Alexander  Monro  on  Small-Pox  and  Vaccination. 


repeated  inoculations,  nay,  bad  there  even  been  no  fever  observed  in  consequence  of  the 
inoculation,  yet  as  the  pustule  occasioned  by  the  last  puncture,  bad  been  suddenly  ac¬ 
celerated  in  its  progress  to  maturation,  at  the  time  the  general  or  constitutional  affectien 
should  have  appeared,  this  alone  was  a  sufficient  proof  of  the  presence  of  the  variolous 
action  in  the  system. 

“  Judging  again  from  analogy,  I  expected  that  the  same  thing,  which  thus  happened 
in  the  small-pox  inoculation,  might  also  take  place  in  that  for  the  cow-pox  ;  and  the 
unexpected  appearance  of  one  or  two  vesicles  upon  children  that  I  had  inoculated, 
which  vesicles  were  quite  characteristic  of  the  ailments,  and  the  appearance  of  which  I 
could  only  account  for  from  a  second  and  accidental  inoculation  during  the  course  of  the 
disease,  strengthened  my  hopes.  And  certainly,  if  we  find  in  cow-pox,  when  the  in¬ 
flamed  and  hard  areola  does  not  take  place,  at  least  in  the  regular  eourse  of  that  affec¬ 
tion,  until  the  end  of  the  seventh  or  beginning  of  the  eighth  day  from  inoculation,  per¬ 
formed  for  example  at  the  end  of  the  fifth  or  beginning  of  the  sixth  day,  is  so  much  ac¬ 
celerated  in  its  progress,  about  the  time  the  general  affection  of  the  system  usually  takes 
place,  as  to  have  an  areola  formed  within  a  few  hours,  or  very  shortly  after  the  first,  and 
that  this  areola  increases  with  the  first,  and  again  fades  at  nearly  the  same  time,  we  must 
be  struck  with  the  similarity,  and  be  forcibly  led  to  draw  the  same  conclusion  in  this  case 
as  in  the  former,  respecting  the  small-pox,  viz  :  that  although  the  inoculated  affection 
had  appeared  very  slight,  and  no  fever  had  been  observed,  yet  that  a  certain  action  had 
been  excited  in  the  constitution.  That  this  M  as  the  true  constitutional  affection  of  cow- 
pox,  may  be  judged  by  the  acceleration  of  the  second  vesicle  to  a  state  of  maturity,  five 
days  before  this  could  have  happened,  had  there  been  no  consentaneous  general  action  or 
change  in  the  system.  * 

“  The  truth  of  this  opinion  ivas  also  soon  put  to  the  test  of  experience;  and  I  have 
now  much  satisfaction  in  declaring  that  the  result  appears  to  answer  my  most  sanguine 
expectations. 

“In  short,  my  observations  on  this  point  lead  me  to  conclude,  that,  in  order  to  obtain 
the  proposed  criterion  in  the  greatest  perfection,  the  second  inoculation  should  be  per¬ 
formed  between  thirty-six  and  forty-eight  hours  before  the  areola  of  the  first  inoculation 
begins  to  appear.  This  is  necessary,  in  order  that  the  secondary  affection  may  have  pro¬ 
ceeded  some  length,  and  that  a  small  vesicle  containing  virus  may  have  been  formed  by 
it,  before  the  constitutional  action  from  the  first  inoculation  begins,  otherwise  no  areola 
but  merely  a  slight  degree  of  hardness  will  take  place  from  the  second  puncture. 

“As,  on  the  one  hand,  the  acceleration  of  the  second  inoculation  in  the  manner  above 
mentioned  is  to  be  regarded  as  a  certain  mark  of  a  constitutional  affection  in  cow-pox, 
so,  on  the  other,  if  it  shall  be  found  that  no  such  acceleration  takes  place,  but  that  the 
second  inoculation  proceeds  by  a  sIotv  progress  through  all  the  stages,  and  has  the  dura¬ 
tion  of  a  primary  affection,  it  is  to  be  concluded  that  no  constitutional  action  has  taken 
place  from  the  lirst  insertion  of  the  virus,  and  when  this  is  the  case,  the  second  inocula¬ 
tion  must  be  regarded  as  a  primary  affection,  and  a  third  puncture  be  made  according  fo 
the  plan  laid  down  for  conducting  the  second  inoculation  ;  and  thus  we  may  go  on  until 
the  proper  tests  be  obtained,  or  until  we  be  satisfied  that  the  constitution  completely 
resists  the  action  of  cow-pox.” 

The  directors  of  the  cow-pox  institution  of  Dublin,  in  their  annual  report 
for  181 7,  professed  themselves  utterly  incredulous  of  danger  from  the  srnall- 
jiox,  after  vaccination,  conducted  with  due  attention,  to  Testing  Accord¬ 
ing  to  Mr.  Bryce’s  Plan  (when  practicable,)  to  the  formation  of  the 
areola,  and  of  the  scabbing  process  from  the  twelfth  to  the  thirteenth  or 
fourteenth  day  on  an  average  :  they  had  reason  to  believe  that  many  prac¬ 
titioners  were  not  sufficiently  attentive  to  the  formation  of  the  areola  and 
scab. 

The  test  of  Mr.  Bryce  had  met  with  the  approbation  of  Dr.  Jenner  as 
early  as  the  year  1803.  Thus  in  a  letter  to  Mr.  Bryce,  dated  April  5,  1803, 
Dr.  Jenner  says : 

“  I  must  admire  your  precaution  in  using  a  test  of  the  certainty  of  infection  ;  and 
your  iugeutiity  in  the  manner  in  which  you  employ  it.  Ou  all  young  vaccinators  it 
cannot  be  too  strongly  enjoined.  The  experienced  will  determine  from  the  character  of 
the  pustule.  The  evidence  before  the  House  of  Commons  evinces  the  propriety  of  your 
observations. 

•T  put  your  crust  into  the  hands  of  my  friend  Ring,  and  he  informed  me  yesterday 
that  it  had  produced  a  good  pustule.  Eqarience  notv  tells  us  this  is  a  good  mode  of 
sending  the  vaccine  virus  to  distant  parts.” 


Opinion  of  the  Medical  Profession  in  1818. 


139 


OPINION  OF  THE  MEDICAL  PROFESSION  IN  1818,  AS  TO  THE 


PROTECTIVE  POWER  OF  VACCINATION  AGAINST  THE 


SMALLPOX. 


The  public  and  professional  mind  was  much  agitated  by  the  appearance 
of  an  eruptive  disease  resembling  small-pox,  and  apparently  produced  by 
small-pox  infection,  in  many  persons  who  had  been  formerly  vaccinated, 
during  the  years  1817  and  1818,  and  the  following  questions  were  seriously 
propounded  in  less  than  a  quarter  of  a  century  after  the  promulgation  of 
the  Inquiry  of  Edward  Jenner  on  the  variolse  vaccinse: 

1.  In  what  proportion  do  failures  occur  in  vaccination  ? 

How  many  cases  ot  small  pox  or  varioloid  occur  in  any  given  number  of 
vaccinated  persons  exposed  to  the  variolous  poison  ? 

2.  To  what  is  it  owing  that  vaccination  proves  a  preventive  against  small¬ 
pox  in  some  cases,  and  fails  in  others?  Is  it  owing  to  the  constitution  of 
the  individual?  Is  it  owing  to  the  vaccine  virus  with  which  they  are  in¬ 
oculated  ?  Is  it  owing  to  the  manner  of  vaccination  ?  Is  it  owing  to  the 
progress  and  treatment  of  the  cow-pox  ? 

3.  Has  the  vaccine  virus  frequently  deteriorated,  from  the  employment 
of  lymph  in  succession,  from  vesicles  which  had  not  gone  through  the  stages 
with  perfect  regularity?  Has  the  imperfect  vaccine  vesicle  thus  pro¬ 
duced  the  power  of  rendering  the  human  frame  susceptible  of  none  but 
the  mitigated  form  of  small  pox? 

Is  it  true,  that  by  improper  treatment,  by  accident,  or  by  puncturing 
the  vaccine  vesicle  too  freely,  enough  of  the  virus  to  affect  and  secure  the 
constitution  will  not  be  left  to  be  absorbed? 

4.  How  does  the  degree  of  protection  differ?  Is  it  absolute  in  any  case  ? 
Are  there  cases  in  which  it  is  capable  of  resisting  the  most  powerful  ap¬ 
plication  of  the  variolous  virus,  while  others  are  susceptible  of  its  slight¬ 
est  application  ?  or,  do  the  degrees  of  protection  pass  insensibly  into  each 
other,  from  the  highest  to  the  lowest? 

5.  Does  the  protection  originally  given  gradually  wear  out  as  to  suscep 
tibility  of  infection  ? 

G.  Does  the  protection  originally  given,  gradually  wear  out  as  to  the 
power  of  modifying  subsequent  small-pox,  or  does  it  originally  differ  in  de¬ 
gree? 

7.  In  what  respect  do  the  powers  of  'vaccination,  in  modifying  subse 
quent  smallpox,  differ  from  those  of  natural  and  of  modified  small-pox? 

The  belief  of  the  careful  observers  in  the  Medical  Profession,  in  181.8,  in 
reference  to  the  preceding  queries  may  be  thus  formulated. 

(«,).  Vaccination  seems  to  afford  permanent  protection  against  small¬ 
pox  infection  in  a  large  proportion  of  cases. 

[b) .  In  some  instances ?it  only  affords  imperfect  protection;  or  there  are 
instances  in  which  from' variolous  infection  a  modified  small  pox  is  pro¬ 
duced. 

(c) .  In  some  instances  it  seems  to  afford  only  temporary  protection ;  or 
there  Rare  persons,  who,  after  having  repeatedly  been  exposed  to  variolous 
infection,  are  at  last  inflicted  by  it,  and  pass  through  the  disease  in  a 
modified  form. 


140 


Opinion  of  the  Medical  Profession  in  1818. 


(d) .  In  the  small-pox  modified  by  previous  vaccination,  the  eruptive 
fever  is  often  severe,  the  eruption  sometimes  numerous  and  general,  in 
some  cases  even  confluent,  but  the  pustules  are  smaller,  and  dry  up  on  the 
sixth  and  seventh  days,  without  secondary  fever. 

(e) .  This  modified  small-pox  is  capable  of  infecting  others,  both  by  inoc¬ 
ulation  and  naturally.  It  produces  modified  small  pox  in  persons  previ¬ 
ously  imperfectly  protected  by  vaccination,  and  regular  small-pox  in  those 
who  have  neither  been  vaccinated  nor  had  the  small  pox. 

(/).  In  some  instances,  persons  who  have  previously  had  the  small-pox, 
whether  from  inoculation  or  infection,  have  had  a  second  attack  of  small¬ 
pox,  similarly  modified,  from  exposure  to  variolous  infection  or  from  vario¬ 
lous  inoculation. 

The  constitutional  disorder  thus  excited  is  generally  more  slight  than  a 
first  attack  of  snial  1-pox ;  but  there  have  been  recorded  more  instances  of 
persons  suffering  severely,  nay  fatally,  from  what  was  considered  to  be  a 
second  attack  of  small-pox,  after  what  has  been  considered  perfect  vacci¬ 
nation. 

(g).  There  is  no  evidence  to  conclude  that  the  virus  of  cow-pox  is  dete¬ 
riorated  by  passing  through,  or  being  regenerated  on  a  variety  of  human 
constitutions,  provided  it  be  taken  from  a  regular  vesicle  at  the  period 
when  most  active. 

(/t).  There  is  no  evidence  to  conclude  that  the  protecting  influence  im¬ 
parted  to  the  human  constitution  by  perfect  vaccination,  diminishes  by 
time,  and  ultimately  leaves  the  constitution  as  susceptible  of  small-pox  as 
before  vaccination  was  performed.  In  some  very  rare  instances,  in  which 
persons  are  said  to  have  died  from  the  attack  of  small  pox  after  cow-pox, 
this  occurrence  may  be  fairly  attributed  to  some  error  in  conducting  the 
previous  vaccination  : 

(i)  .  The  same  general  rule  ought  to  be  applied  to  the  small  pox  and  to 
the  cow-pox,  with  regard  to  their  powers  of  protecting  the  constitution  of 
those  who  have  undergone  their  influence,  against  a  future  attack  of  small¬ 
pox. 

( j ) .  The  advantages  arising  to  society  from  propagating  the  cow-pox  in 
place  of  the  small  pox,  are  so  many,  and  so  conspicuous,  as  to  admit  of  no 
hesitation  in  concluding  that  the  former  ought  on  every  occasion  to  be  en¬ 
couraged,  and  the  latter  repressed,  with  the  most  effective  measures  and 
active  exertions. 


DR. 


THOMSON’S 

POX 


THEORY  OF  THE  IDENTITY  OF 
,  AND  MODIFIED  SMALL  POX. 


CHICKEN- 


In  1809  Mr.  Brown  of  Musselburgh,  published  the  opinion  that  the  pro¬ 
phylactic  virtue  of  the  cow-pox  diminished  as  the  time  from  vaccination 
increased  ;  and  this  view  was  strengthened,  by  the  occurrence  of  many  cases 
of  a  mild  form  of  variola,  in  vaccinated  persons,  duringthe  epidemic  of  small¬ 
pox  of  1818  and  1819  ;  and  at  this  time  the  term  modified  small  pox  was 
adopted.  In  addition  to  the  work  of  Dr.  Monro  (published  in  1818),  on 
uthe  different  hinds  of  small-pox,  and  especially  on  that  wh  ich  sometimes  follows 
vaccination  ,”  an  analysis  of  which  has  been  presented,  Dr.  John  Thomson, 
of  Edinburgh,  published  “some  observations  on  the  varioloid  disease  which 
has  lately  prevailed  in  Edinburgh,  and  on  the  identity  of  chicken-pox  and 
modified  small  pox,”  in  a  letter  addressed  to  Dr,  Duncan,  Jr,  dated  fifteenth 


I)r.  Thomson's  Theory  of  Chicken-Pox  and  Modified  Small-Pox.  141 


September,  ISIS,  (Edinburgh.  Medical,  Surgical  Journal  No.  L.,  6).  Dr 
Thomson  reproduced  this  paper  in  his  u  Account  of  the  Variolous  Epidemic 
which  has  lately  prevailed  in  Edinburgh  and  other  parts  of  Scotland etc., 
published  in  1820. 

The  following  is  a  brief  statement  of  the  conclusions  of  Dr.  John  Thom¬ 
son  of  Edinburgh  as  detailed  at  length  in  the  proceeding  publication  : 

1st.  The  varieties  which  appeared  in  the  epidemic  of  1818  convinced  Dr. 
Tliomsou,  that  the  descriptions  which  had  been  given  of  the  appearance 
and  progress  of  the  eruption  in  small-pox  by  the  best  systematic  authors 
are  in  many  respects  imperfect  ;  that  the  diagnostic  marks  which  have  been 
pointed  out  between  small-pox  and  the  disease  that  has  been  termed  chick- 
pox,  are  not  to  be  relied  upon  ;  and  that  no  appreciable  marks  of  distinc¬ 
tion  between  modified  small  pox  and  chicken-pox  have  hitherto  been  es¬ 
tablished. 

2.  It  appears  from  the  records  of  medicine,  that  the  same  person  may 
have  small-pox  twice  or  oftener  during  life. 

3.  It  has  been  incontrovertibly  established  by  Dr.  Jenner  and  his  follow¬ 
ers,  that  cow  pox  lias  the  property  of  rendering  those  who  have  passed 
through  it  much  less  susceptible  of  small  pox  infection  than  they  were  be¬ 
fore;  and  besides  this,  that  it  possesses  also  the  invaluable  property  of 
modifying  the  small-pox  in  those  who  receive  them,  and  of  converting 
them,  from  the  most  fatal  of  all  diseases,  to  one  scarcely,  it  at  all,  fatal. 

4.  By  admitting  that  small  pox  possesses  this  modifying  property,  it  fol¬ 
lows,  that,  in  the  instances  in  which  they  exerted  this  influence,  previously 
to  the  discovery  of  cow-pock,  they  must  have  produced  a  mild  or  less  fatal 
species  of  small-pox,  but  a  species  which  has  not  been  recognized  or  pointed 
out  as  differing  from  natural  small-pox.  If  seems,  therefore,  probable,  that 
this  secondary  small  pox,  must  have  formed  a,  considerable  portion  of  the 
varioloid  eruptions  that  were  former  ly  denominated  the  spurious  small-pox, 
and  afterwards  by  some  the  chicken-pox. 

5.  ■  After  Dr.  Heberden  had  distinguished  chicken-pox  from  small  pox, 
and  had  convinced  himself  and  the  medical  world,  that  these  diseases 
arose  from  two  contagious  poisons,  specifically  distinct  from  each  other,  it 
seems  probable  that  the  cases  of  modified  secondary  small  pox  which  may 
have  occurred,  must  have  been  described  as  cases  of  chicken-pox,  since  we 
nowhere  find  any  hint  of  the  possible  co  existence  of  these  two  diseases, 
or  the  danger  in  which  medical  practitioners  are  of  confounding  them  to¬ 
gether.  - 

u  Can  it  be  that  the  hypothesis  of  the  contagion  of  chicken-pox  being 
specifically  different  from  that  of  small-pox,  has  been  had  recourse  to, 
in  order  to  explain  those  cases  of  secondary  small-pox  which  may  have 
occurred  after  variolous  inoculation,  and  in  the  benevolent  wish  of  vindi¬ 
cating  that  practice  from  the  suspicion  of  being  inefficacious?” 

Dr.  Thomson  regarded  the  epidemical  disease  in  Edinburgh  as  the  same 
with  those  varioloid  diseases  which,  since  the  introduction  of  cow-pox  in¬ 
oculation,  had  been  observed  in  England,  Scotland  and  other  countries,  and 
which  have  been  by  some  medical  practitioners  regarded  as  small  pox,  and 
by  others  as  chicken-pox.  Appendix,  pp.  1-11. 


ESTABLISHMENT  OF  IiE V AGINATION. 

Small  pox  was  epidemic  in  France  in  1820  and  1827,  and  in  the  northern 
part  of  Italy  in  1827  ;  and  in  consequence  of  the  numbers  of  those  vaccin¬ 
ated  who  had  been  attacked  by  smalhpox  more  or  less  modified  or  unmod- 


142 


Establishment  of  Re- Vaccination. 


» 


ified,  the  practice  of  Revaccination  commenced  in  Prussia,  and  the  Ger¬ 
man  States,  and  was  subsequently  encouraged  by  their  governments. 

In  1832-4  small-pox  prevailed  epidemically  in  Ceylon,  when  a  considera¬ 
ble  number  of  those  vaccinated  died;  and  it  made  great  devastations  in 
Hindoostan  on  several  occasions,  both  prior  and  subsequently  to  this  date, 
and  many  of  those  vaccinated  were  carried  off  with  it.  Dr.  Gregory  states 
that  the  admissions  into  the  Small  pox  Hospital  in  1838,  more  than  doubled 
the  average  number  received  annually,  prior  to  the  discovery  of  vaccina¬ 
tion,  and  that  two-fifths  of  the  admissions  consisted  of  persons  who  had 
been  vaccinated.  Many  of  them  had  the  disease  severely  and  more  than 
twenty  of  the  number  died. 

Some  of  the  earliest,  and  at  the  same  time  most  conclusive  testimony  in 
favor  of  Re  vaccination,  was  furnished  by  its  results  in  the  Wurtemberg, 
Hanoverian,  Bavarian,  and  especially  in  the  Prussian  armies. 

Revaccination  was  first  commenced  systematically  in  the  Prussian 
armies  in  the  year  1833,  after  having  been  practiced  in  the  Wurtemberg 
army  and  among  smaller  bodies  of  men  for  several  years  previously,  and 
recommended  by  several  leading  practitioners,  and  has  been  continued  in 
that  and  several  other  armies,  and  also  among  large  bodies  of  citizens. 

The  following  have  been  recorded  as  the  results  of  revaccination  : 

In  Wurtemberg  but  one  case  of  variola?  occurred  in  five  years  among 
14,384  revaccinated  soldiers,  and  three  only  among  26,864  revaccinated 
civilians. 

Rot  a  single  case  of  small  pox  occurred  among  those  who  had  been  re¬ 
vaccinated  in  the  Prussian  army  in  1836,  1837,  or  1839. 

But  three  deaths  by  this  disease  occurred  in  all  the  military  hospitals  of 
Prussia  in  1841,  and  of  these,  one  was  in  a  person  not  vaccinated  on  enter¬ 
ing  the  army,  because  it  had  been  done  shortly  before ;  a  second  in  a  recruit 
who  had  not  been  re  vaccinated ;  and  the  third  in  an  officer  who  had  been 
revaccinated  some  years  before,  but  without  success. 

In  1834  two  deaths  are  recorded  of  those  who  had  been  revaccinated  with 
effect  in  the  Prussian  army,  and  one  in  1843.  In  1849  but  one  case  was 
fatal,  and  this  was  in  a  recruit  vaccinated  when  a  child,  and  who  had  not 
yet  been  re  vaccinated. 

During  an  epidemic  of  small-pox  in  Copenhagen,  in  1828  to  1832,  and 
another  in  1835,  but  a  single  case  of  variolous  or  varioloid  disease  was  ob¬ 
served  among  any  who  had  been  re  vaccinated. 

In  the  Danish  army,  of  those  who  were  successfully  revaccinated  in  1838, 
not  one  was  attacked  with  small-pox. 

In  an  epidemic  of  variola  at  Heidelburgh,  in  1843  and  1844,  described 
by  Dr.  Hmfie,  of  all  those  attacked  not  a  single  one  had  been  previously 
revaccinated,  while  the  vaccinations  most  successfully  made  did  not  pro¬ 
tect  from  the  most  severe  varioloid  those  older  than  ten  years. 

Steinbrenner,  as  the  result  of  extensive  investigation  of  the  subject 
says,  “Revaccination  is  the  indispensable  complement  of  the  first  vaccina¬ 
tion,  not  that  it  is  always  necessary,  as  some  pretend  who  admit  the  loss 
of  its  protective  power  by  time,  but  because  it  is  necessary  in  very  many 
cases,  and  because  there  is  no  other  means  of  distinguishing  such  urgent 
cases  from  those  in  which  revaccination  is  unnecessary.”  (Traite  stir  la 
Vaccine,  p.  684.) 

Steinbrenner  derives  his  arguments  in  favor  of  revaccination  from  its 
effects  in  the  different  European  armies,  as  well  as  when  performed  by  va¬ 
rious  individuals  on  a  small  scale,  of  which  he  presents  a  long  array;  and 
says  that  in  the  absence  of  every  other  argument,  those  results  are  strongly 


143 


Professional  Views  Held  in  1839. 


in  its  favor,  because  it  is  impossible  that  the  process  should  be  so  often 
successful  unless  the  success  depended  upon  a  predisposition  which  ex¬ 
posed  the  individuals  to  variola. 

M.  Bosquet  says,  after  giving  a  long  list  of  instances  of  protection  by 
revaccination  without  a  failure,  even  in  the  midst  of  epidemics,  “  There  has 
not  been  an  epidemic  which  has  not  proved  at  the  same  time  the  virtues 
both  of  vaccination  and  revaccination.  The  success  of  revaccination  is  at 
the  same  time  the  effect  and  the  proof  of  the  wants  of  the  system.  When 
it  succeeds,  it  not  only  proves  that  the  protective  power  of  vaccination  is 
diminished,  but  it  supplies  a  remedy  for  this  diminution.”  (Nouveau 
Traite  a  la  Vaccine,  Paris,  1848,  p.  500.) 

The  following  are  the  conclusions  on  this  subject  of  the  Committee  on 
Vaccination,  of  the  French  Academy,  as  contained  in  their  report  to  this 
body  in  February,  1845: 

1.  Small-pox  rarely  attacks  those  who  have  been  vaccinated  before  the 
age  of  ten  or  twelve,  from  which  age,  until  thirty  or  thirty-five,  they  are 
particularly  liable  to  small  pox. 

2.  Re- vaccination  is  the  only  known  method  of  distinguishing  those  vac¬ 
cinated  persons  that  remain  protected  from  those  that  do  not. 

3.  The  success  of  re-vaccination  is  not  a  certain  proof  that  the  person  in 
whom  it  succeeds  was  liable  to  contract  small-pox  ;  it  merely  establishes  a 
tolerably  strong  presumption,  that  he  was  more  or  less  liable  to  take  it. 

4.  In  ordinary  periods,  re  vaccination  should  be  practiced  after  fourteen 
years,  but  sooner  during  an  epidemic. 

The  following  are  among  the  conclusions  of  a  report  on  the  subject  of 
vaccination  made  by  a  committee  to  the  Belgian  Academy  of  Medicine. 

As  the  immunity  conferred  by  vaccination  is  not  indefinitely  absolute,  re- 
vaccination,  at  least  for  a  great  number  of  individuals  is  rationally  vindi¬ 
cated. 

Experience  has  proved  that  a  recent  re- vaccination  preserves  from  va¬ 
riola  and  varioloid,  and  that  practiced  on  a  sufficient  scale,  conjointly  with 
vaccination,  it  constitutes  a  sure  means  of  arresting  the  progress  of  this 
malady  when  it  appears  epidemically. 

It  succeeds  but  in  proportion  as  it  is  most  required,  that  is,  the  more  re¬ 
mote  the  period  since  the  individual  had  variola,  or  has  been  vaccinated. 

During  the  prevalence  of  an  epidemic  of  variola  or  varioloid,  it  is  pru¬ 
dent  to  re-vaccinate  all  those  whose  first  vaccination  dates  ten  years  back, 
and  all  those  whose  first  vaccination  gives  rise  to  any  doubts.  (Brit  & 
For,  Md.  Cliir.  Rev.,  January,  1851.) 


PROFESSIONAL  VIEWS  HELD  IN  1839,  AS  TO  CORRECT  VAC¬ 
CINATION  AND  IMPEDIMENTS  THERETO. 

In  the  able  “Report  of  the  section  appointed  to  inquire  into  the  present 
state  of  vaccination,”  read  at  the  Anniversary  Meeting  of  the  Provincial 
Medical  and  Surgical  Association,  held  at  Liverpool,  July  25,  1839 ;  the 
Reporter  observes  011  the  discrepancy  that  obtains  in  the  statements 
and  ideas  of  medical  men  upon  the  protective  influence  of  vaccination  : 

1.  The  only  perfect  test  is  the  insertion  of  variolous  lymph.  This,  how¬ 
ever,  is  obviously  objectionable. 

2.  The  regular  progress  of  the  vaccine  vesicle.  To  determine  this,  the 
’surgeon  should  note  it  at  proper  periods.  The  genuine  disease  can  only 
be  produced  by  pure  lymph  from  a  regular  source.  The  time  for  taking 
this  lymph,  according  to  Dr.  Jenuer,  is  between  the  fifth  and  eighth  days, 


144 


Professional  Views  Held  in  1839. 


and  before  the  formation  of  the  areola.  Others  have  recommended  the 
use  of  the  lymph  taken  at  a  much  latter  period,  but  this  they  believe  to 
be  a  very  questionable  practice. 

3.  Jenner  proposed  that  some  fresh  vaccine  lymph  should  be  inserted 
into  the  patient  after  the  first  vaccination.  This  practice  was  founded  on 
the  observation  that  the  second  vaccination  proceeds  with  accelerated 
speed,  provided  the  first  lias  taken  effect.  It  is  a  very  simple  and  beautiful 
illustration  of  the  constitutional  effects  of  vaccination  and  deserves  to  be  en¬ 
couraged.  An  experienced  eye  will  for  the  most  part  be  able  to  detect  any 
deviation  from  the  true  vesicle. 

4.  The  character  of  the  lymph  employed;  it  never  ought  to  be  taken 
from  a  vesicle  which  deviates  in  the  least  degree  from  the  perfect  standard, 
or  from  a  patient  laboring  under  any  cutaneous  disease. 

5.  A  point  which  ought  ever  to  be  insisted  upon,  is  the  leaving  one  or 
more  vesicles  to  run  their  course  without  being  in  any  way  disturbed. 

(>.  The  appearance  of  the  cicatrix;  the  reporters  think  that  this  has  been 
too  much  trusted,  They  are  inclined  to  believe  that  though  the  presence 
of  a  perfect  cicatrix  is  not  a  sure  sign  of  protection,  its  absence  mu^;  be 
held  to  speak  strongly  against  the  existence  of  vaccine  influence.  Yet  the 
observation  of  Mr.  Dodd  would  seem  not  to  bear  out  this  impression.  Of 
fifty.seven  cases  that  have  been  exposed  to  the  contagion  of  small  pox  and 
escaped,  in  six  only  was  the  cicatrix  perfect ;  in  fourteen  it  was  slightly 
defective;  in  thirty  it  was  very  imperfect;  and  in  seven  it  was  totally 
wanting.  Out  of  seventy-seven  cases  of  small  pox  after  vaccination,  one 
bore  a  perfect  mark,  fourteen  had  the  cicatrix  slightly  defective,  forty- 
seven  were  imperfect,  and  fifteen  had  none  at  all.  Thus,  to  sum  up  the 
whole,  out  of  one  hundred  and  thirty-four  cases  of  vaccinated  persons  who 
had  been  exposed  to  small-pox,  the  cicatrices  of  seven  were  perfect,  and 
one  of  these  failed  ;  twenty-eight  slightly  defective,  of  which  fourteen 
failed;  seventy-seven  very  imperfect,  forty-seven  of  which  failed;  twenty- 
two  had  no  mark  at  all,  and  of  them  fifteen  had  small -pox,  while  seven  al¬ 
together  escaped. 

7.  Vaccine  lymph,  though  passed  through  a  great  number  of  subjects, 
and  used  for  a  great  number  of  years,  does  not  necessarily  become  deter¬ 
iorated.  This,  however,  can  oidy  be  said  when  unceasing  attention  is  paid 
to  every  successive  transmission  ;  for  if  a  deviation  commences,  it  may  be 
perpetuated,  and  afford  a  gradually  decreasing  protection.  There  is  no 
doubt  that  lymph  of  this  kind  have  been  often  used. 

8.  The  influence  of  cutaneous  diseases  on  the  vaccine  vesicle  has  been 
insufficiently  attended  to.  Dr.  Jenner  pointed  out  that  the  affection  was 
very  much  modified  in  its  progress  by  the  scaly  tetter,  and  those  affections 
described  by  Dr.  Willan  under  the  term  psoriasis,  as  well  as  those  vesicu¬ 
lar  eruptions  commonly  called  herpetic,  lie  observes  that  vaccination 
performed  on  a  skin  occupied  by  any  of  these  diseases,  “produces  every 
gradation  from  that  slight  deviation  from  perfection,  which  is  quite  imma¬ 
terial,  up  to  that  point  which  affords  no  security  at  all.” 

9.  Other  constitutional  peculiarities  stand  in  the  way  both  of  human 
small-pox  and  cow-pox.  Some  resist  these  affections  at  one  period  of  their 
lives  and  not  at  another;  and  there  are  examples  of  the  very  opposite  con¬ 
dition,  which  show  that  the  individual  will  receive  either  infection  as  often 
as  it  is  presented  to  him  These  peculiarities  frequently  run  in  families. 
We  know  several  children  of  the  same  parents  who  have  had  morbific 
small  pox  after  cow-pox;  and  not  many  months  ago  three  brothers  had 
small-pox  after  cwo-pox,  one  of  these  cases  proving  fatal.  On  this  sub- 


History  of  Small-Fox  by  Moculation. 


145 


ject  we  have  illustrations  from  Mr.  Dodd,  who  tells  us  that  six  brothers  and 
sisters  in  one  family  having  been  vaccinated  when  children,  had  the  small  • 
pox  a  few  years  afterwards. 

In  another  instance,  two  sisters  vaccinated  in  infancy,  were  subsebuently 
inoculated  and  had  the  small-pox  slightly,  they  both  had  it  again  in  1837, 
and  one  of  them  had  it  very  severely.  Their  father  caught  the  small  pox; 
their  mother  too,  who  was  inoculated  when  young,  had  it  again  in  the  same 
year;  their  maternal  grandfather,  beholding  from  a  window  at  night,  the 
funeral  of  a  friend  who  had  died  of  small-pox,  sickened  of  that  disease  and 
died.  There  are  a  few  of  the  affiuities  and  concordances  between  human 
small-pox  and  cow  small  pox ;  and  we  doubt  not  that  every  subsequent  ob¬ 
servation  will  establish  the  analogies.  In  confirmation  we  further  remark, 
that  the  great  object  of  inoculation  with  human  small-pox,  was  to  produce 
an  affection  as  much  like  that  of  cow-pox  as  possible,  and  by  great  care  in 
selecting  the  virus  to  be  employed  this  was  sometimes  accomplished  in  a 
very  remarkable  degree.  On  the  other  hand,  it  is  known  that  the  disease, 
when  casually  caught  from  the  horse  or  cow,  is  often  a  severe  one — as 
severe,  it  was  said  by  an  experienced  observer,  as  for  the  most  part  was  in¬ 
oculated  small  pox.  We  ourselves  have  seen  it,  when  caught  from  the 
horses,  exhibiting  great  intensity,  the  hands  and  arms  being  covered  with 
the  eruption.” — Transactions  of  the  Provincial  Medical  and  Surgical  Associa¬ 
tion  Instituted  1832,  Vol.  S.,p.  39.  Medico  Chirurgical  Review,  Oct.,  Vol.  37, 
1840. 


ON  THE  COMPARATIVE  ADVANTAGES  OF  THE  INOCULATED 
SMALL  POX  AND  OF  THE  COW-POX— HISTORY  OF  SMALL. 
POX  INOCULATION— MORTALITY  OCCASIONS!)  BY  NATU¬ 
RAL  SMALLPOX,  INOCULATED  SMALL  AND  COW-POX- 
STATISTICS  ILLUSTRATING  THE  GREAT  BENEFITS  CON¬ 
FERRED  ON  THE  HUMAN  RACE  BY  VACCINATION. 


HISTORY  OF  SMALL  POX  BY  INOCULATION. 

The  Roman  Empire  was  finally  overturned  by  the  Northern  Barbarians 
in  the  sixth  century  of  the  Christian  era ;  from  that  event  literature  and 
art  lay  for  many  centuries  afterward  buried  in  the  ashes  of  Rome.  The 
crash  of  this  immense  colossus  was  soon  succeeded  by  another  memorable 
catastrophe ;  the  Arabians,  in  622,  under  Mahomet,  sallied  forth  from 
the  East,  sword  in  hand,  to  propagate  his  religion,  and  with  rapidity  sub¬ 
dued  several  great  kingdoms  and  princes  in  the  West. 

Three  new  diseases,  the  small-pox,  the  measles,  and  the  spina  ventosa, 
were  first  described  by  the  Arabians.  The  two  former  diseases  had  never 
before  been  seen  in  any  part  of  the  globe  frequented  by  Europeans;  at 
least  no  history  of  them  has  been  found  in  any  ancient  medical  author, 
poet  or  historian  of  either  Greece  or  Rome.  Mahomefs  folloAvers  are  said 
to  have  exported  these  two  specific  poisons  from  the  deserts  of  Arabia. 
Variolous  poison  was  soon  spread  by  the  Mahomedans  through  Palestine, 
Syria,  Egypt,  Persia,  Spain,  and  wherever  they  carried  their  victorious 
arms.  Many  centuries  after,  the  Crusades,  or  Holy  Wars,  were  instrumen¬ 
tal  in  diffusing  this  exotic  venom  more  widely  over  Europe. 


146 


History  of '  Small-Pox  by  Inoculation. 


The  small-pox  and  measles,  thus  introduced  by  the  Mahomedans,  un¬ 
peopled  more  of  Europe  than  all  the  fiercest  wars  or  blood}7  exploits  with 
which  its  annals  are  stained. 

The  exact  time  and  place  of  the  origin  of  the  small-pox  is  shrouded  in 
mystery;  for  it  must  be  considered  as  a  most  extraordinary  circumstance 
so  contagious  a  disease,  the  poison  of  which  adheres  to  clothes,  linen, 
woolen,  cotton  and  porous  materials,  during  a  long  time,  and  has  in  this 
way  been  conveyed  to  very  distant  kingdoms,  could  have  been  circum¬ 
scribed,  and  its  ravages  confined  for  several  thousand  years  to  a  small 
corner  of  the  globe,  not  divided  by  sea,  from  the  rest  of  Asia. 

Dr.  Mead  thinks  that  the  small-pox  was  nrst  generated  in  the  hot  climate 
of  Ethiopia,  and  together  with  the  plague,  transported  from  thence  across  the 
narrow  channel  of  the  Red  Sea  into  the  opposite  continent,  Arabia  ;  but  if 
small-pox  had  been  a  disease  anciently  known  in  Ethiopia  (which  no  one 
has  proved)  there  were  various  opportunities  for  the  infection  being  car¬ 
ried  down  the  Nile  into  Nubia  and  the  heart  of  Egypt,  countries  bor¬ 
dering  on  Ethiopia  and  of  the  remotest  antiquity  in  arts  and  civilization, 
holding  at  various  times  commercial  and  military  relations  with  the  nations 
of  Africa,  Europe  and  Asia.  The  Romans  in  the  height  of  their  glory  and 
after  the  conquest  of  Egypt,  carried  on  a  considerable  trade  with  Arabia 
and  India;  one  hundred  and  twenty  vessels  sailed  annually  down  the  Red 
Sea,  traversed  the  Arabian  coast,  and  arriving  at  the  Malabar  shores  in 
India,  and  the  Island  of  Ceylon,  returned  from  thence  loaded  with  cin¬ 
namon,  pepper,  ginger,  silk,  pearls  and  diamonds.  Mecca,  the  birth  place 
of  the  Mahomedan  prophet,  stands  on  the  borders  of  the  Red  Sea. 
Throughout  all  this  intercourse  of  great  nations,  variolous  infection,  seems 
not  to  have  been  dispersed  amongst  the  great  kingdoms,  bordering  on  the 
Mediterranean,  Red  Sea,  and  Indian  Ocean. 

Mr.  Holwell,  who  resided  a  great  part  of  his  life  in  India,  published 
about  the  middle  of  the  eighteenth  century,  a  treatise  on  the  practice  of 
Inoculation,  and  the  treatment  of  Inoculated  Small-Pox,  in  Hindos- 
tan.  Mr,  Holwell  states  that  it  is  believed  in  India,  that  Small-pox  raged 
there  time  immemorial,  and  that  the  Brahmins  or  priests,  time  out  of  mind, 
have  practiced  Inoculation.  The  Turks  ascribe  the  origin  of  the  prac¬ 
tice  to  Circassia,  formerly  one  of  the  Asiatic  provinces  of  Turkey.  It  has 
been  conjectured,  therefore,  that  it  is  to  India,  that  Europe  is  originally 
indebted  for  this  important  discovery  through  the  medium  of  the  Circas¬ 
sians. 

Neither  Rhazes,  Avicenna,  nor  any  of  the  Arabian  physicians,  who 
wrote  in  the  ninth  or  tenth  centuries,  make  the  least  mention  of  Inocula¬ 
tion  ;  had  variolous  poison  been  transported  from  India  to  Arabia,  the 
physicians  of  the  latter  nation  could  not  have  remained  ignorant  of  a 
practice,  according  to  Indian  tradition,  so  universal  and  ancient,  and  at¬ 
tended  with  such  happy  consequences. 

Inoculation  in  India  is  performed  by  a  particular  tribe  of  Brahmins, 
who  were  delegated  annually  for  that  purpose,  and  who  made  a  tour  or  sep¬ 
arate  circuits  in  traveling  parties  to  inoculate  the  distant  provinces  ;  arriv¬ 
ing  at  the  place  of  destination  a  few  weeks  before  the  return  of  the  natural 
disease.  The  inhabitants  who  intend  to  have  themselves  or  children  in¬ 
oculated,  know  the  time  of  the  Brahmin’s  arrival,  and  abstain  according  to 
established  rules  universally  known,  for  one  month  before  the  inoculators’ 
periodical  visitation,  from  fish,  milk,  and  a  kind  of  butter  made  of  Buffa¬ 
lo’s  milk;  this  is  the  invariable  and  only  preparatoy  regimeu. 


history  of  Small-Pox  by  Inoculation. 


147 


The  Brahmins  inoculate  generally  on  the  outside  of  the  arm,  the  male 
about  the  middle,  between  the  wrist  and  the  elbow;  the  female  between  the 
elbow  and  shoulder.  The  operator  first  rubs  the  parts  with  a  dry  cloth 
during  eight  or  ten  minutes ;  then  with  a  small  instrument  made  like  a 
crow-quill,  and  sharp  at  the  point,  he  makes  in  a  small  space,  which  might 
be  covered  with  a  silver  six-pence,  several  slight  scratches,  so  that  the 
smallest  appearence  of  blood  may  be  perceptible ;  a  pledget  impregnated 
with  variolous  matter  is  then  applied,  after  being  wetted  with  a  little  water 
from  the  Ganges;  over  all  a  bandage  is  rolled  ;  six  hours  after  the  bandage 
is  removed,  and  the  cotton  left  to  fall  off  of  its  own  accord. 

Variolous  matter,  taken  from  Inoculated  small  pox,  of  the  preced¬ 
ing  year  is  generally  used  for  inoculation  ;  but  is  never  received  or  preferred 
from  natui  al  small-pox ,  however  mild  and  distinct.  There  are  many  instances, 
says  Mrs.  Hoi  well,  of  the  variolous  matter  entangled  with  cotton,  and  kept 
close  stopped  from  the  air  in  a  bottle  during  five  or  six  years,  at  the  end  of 
this  period  proving  active. 

The  same  careful  regimen  in  diet  is  continued  through  the  disease,  as 
before  inoculation.  Every  morning  before  sunrise,  or  every  evening  after 
sunset,  the  patients,  from  the  first  day  after  inoculation,  are  stripped 
naked,  and  sluiced  over  the  head  and  body  with  buckets  of  cold  water ;  in 
this  manner  the  diurnal  cold  bathing  is  continued  until  the  eruptive  fever 
comes  on,  which  by  such  means  is  rather  hastened,  and  commences  about 
the  close  of  the  sixth  day.  Then  during  a  few  days  of  the  eruptive  fever , 
they  desist  from  cold  bathing  ;  but  on  the  pustular  eruption  appearing  on 
the  surface,  which  is  generally  a  process  of  three  days,  they  again  resume 
the  cold  water,  and  continue  it  to  the  end  of  the  disease.  The  variolous 
pustules  when  ripe  are  all  opened  with  a  pointed  thorn.  Every  pustule  is 
considered  as  a  small  abscess,  or  boil,  that  has  reached  maturation,  and 
whose  matter  should  be  drained  off  by  an  external  opening. 

About  a  dozen  pustules  are  opened  with  great  gentleness  at  one  time, 
then  the  matter  is  absorbed  with  a  linen  or  cotton  rag  dipped  in  warm 
water  and  milk ;  in  this  way  they  proceed  gradually  over  the  whole  body, 
face  and  extremities.  A  cooling  regimen  is  prescribed  through  the  disease ; 
the  inoculated  are  forbidden  to  confine  themselves  to  the  houses,  and  are 
exposed  very  freely  to  the  air  and  wind  ;  all  the  fruits  of  the  climate  are 
permitted  such  as  plantain,  sugar  cane  and  watermelons;  and  cold  water, 
or  rice^  gruel  used  for  common  drink.  The  number  of  pustules  from  inocu¬ 
lation  in  India,  are  generally  fifty  to  one  hundred. 

Mr.  Holwell  affirmed  that  the  process  was  mild  and  that  almost  all  the 
inoculated  recovered.  This  same  authority  has  observed  a  malignant  form 
of  small  pox  in  India,  which  killed  numbers  so  early  as  the  second  or  third 
day,  and  which  attacked  turkeys,  capons,  fowls,  poultry,  parrots  and  other 
species  of  the  feathered  tribe. 

From  the  testimony  of  the  Missionary  Jesuits,  it  appears  that  inocula¬ 
tion  was  practiced  in  Pekin,  China,  only  from  about  the  middle  of  fhe 
seven  teeuth  century. 

The  Chinese  Method  of  Small-Pox  Inoculation,  was  to  roll  up  in 
cotton  a  few  of  the  dried  scabs,  which  had  fallen  off  from  the  variolous 
pustules,  and  which  were  kept  ready  for  use  in  a  bottle  close  stopped  with 
wax  ;  small  pledgets  of  these  were  put  up  the  nostrils  ;  or  the  dried  scabs 
were  powdered  and  sniffed  up  the  nose;  and  in  this  way  the  vascular  mu¬ 
cous  membrane  of  the  nose  the  artificial  disease  was  communicated. 

In  1724,  when  a  virulent  small  pox  was  raging  in  Tartary,  the  Emperor 
of  China  dispatched  the  physicians  of  Ins  court  to  inoculate  the  Tartars, 


148 


History  of  Small-Pox  by  Inoculation. 


There  appears  to  be  no  such  similarity  in  the  Chinese  or  East  Indian 
modes  of  inoculation,  as  to  induce  one  to  refer  them  to  the  same  origin. 

The  earliest  information  in  Britain  of  inoculation,  and  of  its  utility  in 
diminishing’  the  mortality  ot  small-pox,  was  from  Emanuel  Timoni,  a  Greek 
physician,  in  a  letter  to  Dr.  Woodward,  dated  Constantinople,  1713. 

In  1715,  in  another  letter  of  Doctor  Emanuel  Timoni,  to  the  Eoyal  Soci¬ 
ety  of  London,  he  says  that  forty  years  before  the  above  date,  inoculation 
had  been  introduced  into  the  capital  of  Turkey  from  two  of  the  Asiatic 
provinces  bordering  on  the  Caspian  Sea — Circassia  and  Georgia.  An  ac¬ 
count  of  the  Circassian  practice  may  be  found  in  Mot r aye’s  Travels  to  that 
counrry  in  1712.  Kennedy,  another  eye-witness  of  inoculation  (Surgeon  in 
the  English  Army),  published  in  the  same  year  with  Timoni  observations 
on  the  subject. 

Pylarini’s  account  of  Inoculation  at  Constantinople ,  where  he  then  prac¬ 
ticed  medicine,  was  published  at  Venice,  1715 ;  in  which  year  several  thou¬ 
sand  were  inoculated  in  the  Turkish  capital.  The  Turks  themselves,  as 
Mahomedans  aud  fatalists,  rejected  inoculation,  and  it  was  adopted  only 
amongst  the  Greeks,  Armenians  and  Christians.  In  Greece  and  the  adja¬ 
cent  island  of  Candia  it  had  been  a  practice  during  one  or  two  centuries 
earlier.  In  Egypt,  Tripoli,  Tunis,  Algiers,  and  other  provinces  of  Africa 
subject  to  Turkey,  inoculation  had  likewise  been  long  known,  and  had  ex 
tended  so  far  south  on  the  African  Continent  as  the  River  Senegal. 

It  is  stated  that  the  Circassians  and  Georgians  were  induced  to  the  prac¬ 
tice  of  Inoculation  by  an  additional  and  powerful  motive  to  the  security 
against  small-pox,  namely, — avarice,  in  order  to  preserve  the  beauty  of 
their  female  children  and  to  sell  them  at  higher  prices  to  the  rich  Turks  and 
Persians  as  mistresses.  The  variolous  matter  they  transferred  by  a  small 
scratch  made  in  different  parts  of  the  body,  previously  dipping  the  point  of 
the  needle  into  a  ripe  pustule,  or  in  a  nut-sliell  full  of  variolous  infection. 
Many  young  women  of  Constantinople  exercised  the  function  of  inocula- 
tors.  Timoni  says  that  they  were  indifferent  whether  the  variolous  infec¬ 
tion  was  engrafted  from  natural  or  artificial  pustules. 

In  1717,  the  elegant  and  accomplished  Ladj  Mary  Wortley  Montague, 
wife  of  the  English  Ambassador  at  Constantinople,  had  her  son  inoculated 
in  that  capital  by  Maitland,  an  English  surgeon. 

In  1725,  Dr.  Mead  and  Mr.  Maitland  made  the  experiment  of  Chinese 
inoculation  upon  one  of  seven  condemned  criminals  in  Newgate,  and  of 
the  Turkish  practice  upon  the  other  six  ;  all  of  whom  by  that  means  ob¬ 
tained  a  pardon  from  the  King,  and  recovered ;  but  in  the  first  case  the 
brain  was  seriously  affected,  and  a  prejudice  was  engendered  against  the 
Chinese  method. 

In  1722,  on  Lady  Montague’s  return  to  England,  her  young  daughter 
was  inoculated  by  a  slight  incision  on  each  arm,  and  was  the  first  person 
of  any  rank  inoculated  in  that  country.  A  few  months  after  the  Princess 
Royal  and  some  other  members  of  the  Royal  Family  were  inoculated. 

1722.  In  this  year  inoculation  was  carried  to  Boston,  Massachusetts,  in 
North  America,  and  was  attended  with  the  same  favorable  results  as  in 
London,  in  the  handful  who  had  the  resolution  to  entrust  their  lives  to  that 
protection. 

Dr.  Jurin,  from  1723  to  1727,  published  several  detached  papers  in  the 
Philosophical  Transactions  comparing  the  mortality  of  natural  small-pox 
and  the  numbers  lost  by  inoculation.  From  a  great  mass  of  materials,  and 
many  thousands  of  sick  in  different  parts  of  Europe,  he  found  that  one  of 
five,  or  six,  at  a  medium,  died  by  the  natural  disease  ;  for,  in  its  malignity, 


History  of  Small- Box  by  Inoculation. 


149 


there  is  everywhere  in  different  years  various  gradations,  for  in  Turkey,  in 
the  northern  parts  of  Europe,  and  in  Africa,  and  throughout-  the  whole  ex¬ 
tent  of  the  Mediterranean  coast,  small-pox  was  still  more  fatal,  and  it  has 
been  in  many  outbreaks  so  violent  as  to  kill  nearly  one-half  of  the  infected. 

Of  those  then  inoculated,  one  in  fifty  died ;  but  amongst  them  were  in¬ 
cluded  young  infants,  many  of  whom  were  cut  off  by  convulsions,  which 
was  laid  to  inoculation,  and  some  aged  persons,  pregnant  women  and  valet¬ 
udinarians.  Jurin’s  list  of  all  the  inoculated  in  London  and  other  parts  of 
England,  from  1721  to  1727,  amounts  to  only  seven  hundred  and  sixty-four. 

It  is  important  to  note  in  this  connection,  that  in  Wales  a  custom  pre¬ 
vailed  before  the  introduction  of  inoculation  from  Turkey,  of  engrafting 
the  small-pox.  A  small  wound  or  scratch  was  made  on  the  hand  or  arm 
with  a  pin  or  a  knife,  and  the  variolous  matter  rubbed  in  ;  now  and  then 
the  pocky  scabs  were  merely  rubbed  in  the  hollow  of  the  hands.  A  simi¬ 
lar  custom  prevailed  in  some  parts  of  Denmark  in  the  fifteenth  century, 
and  is  related  by  Bartholine. 

Inoculation  from  1727  languished  in  England  and  America  until  1738, 
but  two  (2)  died;  in  the  same  year,  of  one  thousand  inoculated  at  all  ayes  in 
one  province  of  North  America ,  namely,  South  Carolina ,  and  in  the  most  un¬ 
favorable  season,  during  the  sultry  heat  of  June,  July  and  August,  but 
eight  (8)  died. 

Inoculation  was  first  advocated  in  Ncrth  America  by  the  Reverend  Cot¬ 
ton  Mather,  and  was  first  practiced  at  his  suggestion  by  Dr.  Z.  Boylston, 
on  the  twenty-seventh  of  June,  1721,  in  Boston,  upon  his  only  son,  about 
thirteen  years  of  age,  and  two  negro  servants,  and  was  successful.  Dur¬ 
ing  that  year,  or  the  early  part  of  1722,  Dr.  Boylston  performed  inocula¬ 
tion  upon  247  persons — Timelier1  s  American  Medical  Biography ,  Boston, 

1828,  i).  28. 

The  havoc  then  made  by  small-pox,  drove  the  inhabitants  of  Charleston, 
South  Carolina,  to  adopt  the  only  remaining  remedy  from  destruction. 

Middleton,  in  England,  inoculated  eight  hundred  and  lost  but  one.  Other 
inoculators  lost  one  out  of  three  and  four  hundred.  In  the  West  Indian 
Island,  St.  Kitts,  of  three  hundred  negroes  inoculated,  only  one  died. 
Ranby  inoculated  a  thousand  in  England  and  without  a  single  death.  In 
1746  a  small  charitable  hospitable  was  erected  at  Pancras,  in  the  environs 
of  London,  for  the  double  purpose  of  inoculation,  and  to  receive  during  the 
sickness,  persons  of  indigent  circumstances  who  had  been  siezed  with  nat¬ 
ural  small-pox;  of  eighteen  hundred  and  ninety-six  inoculated  in  this  hospital 
in  the  course  of  several  years,  but  eight  died.  At  another  period,  of  four 
hundred  and  ninety-six  inoculated  at  this  asylum,  but  one  died. 

In  the  year  lri 59,  the  number  inoculated  at  Pancras  were,  five  hundred 
and  ninety  three  (593),  and  many  of  these  adults,  yet  but  one  died. 

The  Suttons  in  tbe  seventeenth  century,  by  their  own  computation,  inocu¬ 
lated  throughout  Loudon,  and  many  parts  of  England,  about  forty  thou¬ 
sand,  and  they  assert  they  did  not  lose  one  hundred. 

In  Pennsylvania  and  other  provinces  of  North  America,  of  8000  inocu¬ 
lated,  only  19  died,  or  one  in  467. 

In  1748,  inoculation  was  introduced  into  Amsterdam  by  Dr.  Tronchin, 
who  began  experiments  upon  his  own  son,  and  before  1759,  inoculation 
had  spread  into  several  other  towns  of  Holland. 

In  1774,  a  malignant  small-pox  was  committing  severe  ravages  in  the 
ecclesiastical  state  of  Italy,  and  several  mothers  dreading  the  destruction 
of  their  whole  families,  inoculated  their  children,  when  sleeping,  with  the 
desired  success. 


150 


Mortality  Occasioned  by  the  Inoculated  Small-Pox. 


The  efforts  of  a  few  physicians  and  patriots  of  France  to  introduce  the 
inoculation  failed,  from  the  ignorant  and  bigoted  opposition  of  the  clergy  ; 
and  from  1724  to  1752,  no  person  in  the  medical  profession  of  France  wrote 
upon  inoculation  ;  in  1754,  the  public  attention  in  this  country  was  awak¬ 
ened  by  Mr.  Condamine’s  papers  read  before  the  Academy  of  Sciences,  in 
vindication  of  inoculation,  and  in  1755  and  1756,  a  few  of  the  principal 
nobility  were  inoculated  at  Paris. 

In  1755,  Mr.  Slmltz  returned  to  Stockholm  from  London,  where kehad  been 
sent,  by  order  of  the  Swedish  Court,  to  inquire  into  the  success  and  mode 
of  inoculation,  particularly  at  the  London  Inoculating  Hospital ;  and  in 
that  year  a  small  building  for  a  similar  purpose  was  erected  at  Stockholm. 
Of  1200  inoculated  in  Sweden  before  the  year  1764,  not  one  died.  Den¬ 
mark  adopted  the  practice  about  the  same  time  with  Sweden. 


MORTALITY  OCCASIONED  BY  THE  INOCULATED  SMALL-POX. 

According  to  the  immature  calculations  of  Turin,  of  those  inoculated, 
one  of  fifty,  and  of  Dr.  Mead,  one  of  every  hundred,  died;  but  by  the  ac¬ 
counts  of  later  date,  collected  by  practical  inoculators  and  physicians,  on 
an  ayerage  only  one  of  every  five  hundred  inoculated  die,  and  it  would  seem 
from  Mr.  Holevill’s  statements,  that  this  last  rate  of  mortality  would  also 
apply  to  this  practice  in  India. 

In  the  London  Small-Pox  Hospital,  of  the  last  five  thousand  that  were 
inoculated,  only  one  in  six  hundred  died. 


THE  PRACTICE  OF  INOCULATION  FOR  THE  SMALL  POX,  SUB¬ 
STITUTED  A  COMPARATIVELY  MILD  FORM  OF  THE  DIS¬ 


EASE,  ATTENDED  WITH  BUT  SMALL  MORTALITY;  BUT 
THE  TOTAL  NUMBER  OF  DEATHS  BY  SMALL  POX  WAS 


THEREBY  INCREASED,  AND  THE  PERPETUATION  AND 
SPREAD  OF  THIS  LOATHSOME  PESTILENCE  ON  THE  SUR¬ 


FACE  OF  THE  EARTH,  WAS  PROMOTED  BY  INOCULATION. 


Inoculation  seldom  or  never  fails  to  convey  the  disease  ;  the  pustules  are 
in  general  few,  and  although  only  one  or  two  should  appear,  the  person  is 
X>rotected  against  the  small-pox. 

Exclusive  of  the  immediate  havoc  by  small-pox  in  the  natural  way,  num¬ 
bers  who  survive  are  disngured  for  life;  in  multitudes  of  others,  the 
natural  disease  is  followed  by  phthisis  and  scrofula,  and  a  considerable 
number  are  deprived  of  eye-sight. 


Dr.  W.  Black*  writing  in  1781, 


says : 


“  Others  surmised,  that  infectious 


♦Observations,  Medical  and  Political,  on  the  Small-pox.  etc. :  London,  1781,  p.  41  . 


151 


Mortality  Occasioned  by  the  Inoculated  Small-Pox. 


and  hereditary  diseases  might  be  instituted  together  with  variolous  infec¬ 
tion.  Universal  experience  proves  there  to  be  chimerical  conjectures,  and  in 
the  natural  disease  there  is  greater  danger  of  such  imaginary  combination  of 
infections ;  for  in  chosing  variolous  matter  it  is  easy  to  select  it  from  healthy 
constitutions.  Experiments  have  been  made  with  variolous  matter  taken 
from  persons  laboring  at  the  same  time  under  the  venereal  disease,  yet  the 
latter  affection  was  not  engrafted  with  inoculated  small-pox.  The  true 
scurvy,  however  virulent,  every  common  '  seaman  knows,  is  neither  conta¬ 
gious  nor  infectious,  neither  is  the  scrofula.” 

The  London  bills  of  mortality  show  that  within  one  hundred  years  pre¬ 
ceding  1780,  in  this  city  alone  upwards  of  two  hundred  thousand  people 
had  been  cut  off  by  one  single  disease — small  pox.  An  examination  of  the 
London  bills  of  mortality  as  far  back  as  1629,  when  the  different  diseases 
of  those  who  died  were  first  inserted,  show  that  in  all  the  interval  extend¬ 
ing  to  1780,  the  deaths  from  small-pox  in  any  one  year  did  not  exceed  four 
thousand  5  in  1772,  which  yielded  the  heaviest  mortality  from  this  disease, 
they  numbered  3992 ;  and  it  was  calculated  that  about  two  thousand  inhabi¬ 
tants  were  annually  destroyed  in  London  by  the  small -pox.  If  in  the 
eighteenth  century,  during  the  practice  of  inoculation  and  before  the  intro¬ 
duction  of  vaccination,  the  six  hundred  thousand  inhabitants  of  London 
lost  two  thousand  annually  by  small-pox,  then  throughout  the  nine  millions 
in  Britain  and  Ireland,  thirty  thousand  annual  deaths  should  be  attributed 
to  small-pox. 

In  the  hundred  years  preceding  the  introduction  of  vaccination,  during 
at  least  sixty  of  which  inoculation  was  practiced,  Britain  and  Ireland 
alone  lost  three  millions  of  inhabitants  by  small-pox. 

Baron  Dimsdale,  who  was  sent  from  England  to  inoculate  the  Czarina 
of  Russia,  in  his  treatise  on  small-pox,  says  that  “  this  single  disease  destroys 
more  than  the  eighth  part  of  the  inhabitants. 

“  If,  therefore,  in  London,  which  enjoys  the  many  advantages  already  re¬ 
cited,  more  than  two  thousand  persons  die  annually  of  smallpox ,  we  may 
surely  suppose  that  the  loss  which  Russia  in  its  whole  extent  sustains  in 
the  same  space  of  time,  amounts  to  tico  millions  of  souls.”  P.  16. 

The  learned  Dr.  W.  Black,  however,  on  more  careful  calculation,  founded 
upon  the  best  data  accessible  at  that  time  (1780),  estimating  the  total  pop¬ 
ulation  of  Europe  at  120,000,000,  taking  Britain  and  Ireland  as  a  body,  “the 
annual  deaths  by  smallpox ,  throughout  all  the  kingdoms  of  Europe,  will 
amount  to  only  four  hundred  thousand  ”* 

During  the  practice  of  inoculation  a  question  of  great  importance  to 
mankind  was  agitated,  namely,  whether  by  inoculation  in  London  and 
other  great  cities,  at  the  private  houses  of  the  inhabitants,  contagion  is 
not  more  likely  to  be  dispersed,  and,  upon  the  whole,  the  community  at 
large  more  injured  than  benefited  by  the  practice  I 

The  arguments  urged  chiefly  by  Baron  Dimsdale  and  other  English 
writers,  during  the  latter  part  of  the  eighteenth  century,  may  thus  be  con¬ 
densed. 

Though  the  loss  under  inoculation  is  very  inconsiderable,  almost  the  whole 
of  those  that  are  inoculated  recovering,  yet  by  spreading  the  disease,  a 


Observations  Medical  and  Political  on  tbe  Small -pox,  etc.,  1781,  p.  50. 


152 


Mortality  Occasioned  by  the  Inoculated  Small-Pox. 


greater  portion  take  it  in  the  natural  way;  more  lives  are  note  (1725-1780) 
lost  in  London  than  before  inoculation  commenced ,  and  the  community  at 
large  sustains  a  greater  loss;  the  practice,  therefore,  is  more  detrimental 
than  beneficial  to  society. 

In  the  four  years  preceding  1776,  the  number  of  bills  from  small-pox 
were  at  a  medium  to  2,444,  an  alarming  increase. 

The  disease,  by  general  inoculation  throughout  London,  spreads  by  visit¬ 
ors,  strangers,  servants,  washerwomen,  doctors  and  inoculators;  by  means 
ol  hackney  coaches,  in  which  the  sick  are  sent  out  to  take  the  air,  or  by 
sound  persons  communicating  with  the  sick  in  the  streets. 

The  poor  in  London  are  miserably  lodged ;  their  habitations  are  in  close 
alleys,  courts,  lanes  and  old  dirty  houses;  they  are  often  in  want  of  medi¬ 
cines,  even  of  bedding.  The  fathers  and  mothers  are  employed  constantly 
in  laborious  occupations  abroad,  and  cannot  attend  the  inoculated  sick ; 
should  they  neglect  their  occupations,  food  and  necessaries  would  be  defic¬ 
ient,  and  the  medicines  and  diet  ordered  by  the  physicians  could  not  be 
regularly  complied  with.  The  air  in  their  houses  is  impure,  they  have 
neither  areas,  gardens,  or  carriages  for  the  convenience  of  ventilation  and 
taking  fresh  air. 

Sailors  and  sea  faring  people,  many  of  whose  lodgings  are  miserable  in 
the  little  houses  on  the  river,  are  liable  to  catch  the  distemper,  and  either 
to  fall  sick  there  without  friends  or  assistants ;  or,  perhaps,  being  infected 
on  shore,  to  carry  it  to  sea  in  their  contaminated  clothes,  and  afterwards 
falling  sick  without  care  or  attendance  spread  the  disease  in  foreign  cli¬ 
mates. 

Country  people  coming  to  town  for  markets,  visits,  or  pleasure,  all  are 
subject  to  the  danger  of  the  infection. 

Persons  going  from  the  sick  to  the  General  Inoculating  Hospital,  or  Dis- 
pensories,  for  medicines  or  advice,  scattered  the  disease  in  their  infected 
clothing  in  the  streets  and  whole  neighborhood. 

The  gossiping  disposition  of  the  poor,  the  flocking  of  persons  to  funerals 
of  those  dead  with  the  small  pox,  and  the  sick  sallying  forth  in  the  public 
ways  in  their  dirty  garments  loaded  with  small  pox  infection,  scattered  the 
disease  broadcast.  The  children  who  were  able  to  run  about,  immediately 
upon  their  recovery,  still  farther  scattered  the  seeds  of  the  fatal  disease  by 
intermingling  in  the  streets  and  in  the  schools  with  their  play-fellows. 

The  success,  therefore,  derived  from  general  inoculation  was  beneficial  to 
a  comparatively  few  only ;  whilst  it  misled  a  great  number  of  others  in 
danger  to  which  they  would  otherwise  have  been  less  exposed. 


THE  MORTUARY  STATISTICS  OF  LONDON  DEMONSTRATE 
THAT  INOCULATION  ACTUALLY  INCREASED  THE  MOR¬ 
TALITY  FROM  SMALL  POX. 

On  the  continent  registers  were  instituted  fifty  or  a  hundred  years  before 
their  introduction  in  England  ;  but  general  annual  registers  of  births,  dis¬ 
eases  and  deaths  are  modern  establishments,  and  were  unknown  to  the 
ancients. 

In  1538,  exact  records  of  weddings,  christenings  and  burials,  were  first 
ordered  by  the  King  and  Council  to  be  kept  in  every  parish  and  church 
in  England  by  either  the  vicar  or  the  curate.  This  order  was  Arery  negli¬ 
gently  obeyed  in  many  parishes,  until  1759,  in  Queen  Elizabeth’s  reign, 


Mortuary  Statistics  of  London. 


153 


when  to  prevent  registers  from  rotting  in  damp  churches,  they  were  di¬ 
rected  to  be  written  on  parchment.  At  first,  they  seem,  both  in  Germany 
and  in  England,  to  have  been  designed  to  prove  the  birth,  death  and  de¬ 
scent  of  private  persons,  and  the  rights  of  inheritance  in  property  or 
lands.  In  1592,  a  year  of  pestilence,  bills  of  mortality  for  London  were 
instituted  ;  but  were  discontinued  till  1603,  another  year  of  desolating  pes¬ 
tilence,  which  was  the  only  distemper  then  taken  notice  of  in  the  printed 
reports.  In  1629,  the  different  diseases,  casualties  of  those  who  died,  to¬ 
gether  with  the  distinction  of  sexes  were  added  and  published ;  and  in 
1728,  and  not  sooner,  the  different  ages  of  the  dead  were  ordered  to  be 
specified  in  the  London  bills.  Upon  first  establishing  the  distinction  of 
diseases  and  casualties  in  the  bills  of  the  metropolis  of  England,  the  prim¬ 
ary  intention  appears  to  have  been  to  discern  the  numbers  destroyed  by 
the  plague,  and  to  detect  concealed  murders. 

Since  the  days  of  Moses,  however,  existence  has  been  circumscribed 
within  the  same  narrow  bounds.  In  the  London  bills  of  mortality,  during 
a  period  of  thirty  years,  that  is,  from  1728  to  1758,  the  total  deaths 
amounted  to  750,422,  and  of  this  number  242  only  reached  beyond  100 
years  of  age ;  one  of  whom  arrived  at  the  age  of  138. 

Dr.  W.  Black*  has  recorded  the  following  statistics  illustrating  the 
annual  average  births  and  burials  recorded  in  London  bills  from  1671  to 
1781  : 

LONDON  BILLS  AT  A  MEDIUM  ANNUALLY. 


YEARS. 


From  1671  to  1681. 
From  1681  to  1691 . 
From  1691  to  1700. 
From  1700  to  1705 . 
From  1706  to  1710. 
From  1711  to  1715 
From  1716  to  1720. 
From  1721  to  1725. 
From  1726  to  1730  . 
From  1731  to  1735 
From  1736  to  1740 
From  1741  to  1745 
From  1746  to  1750. 
From  1751  to  1756 . 
From  1759  to  1768. 
From  1770  to  1780 


Christenings. 


Burials . 


12,325 

14.439 

14,938 


19,144 

22,763 

20,770 


15,750 

21,091 

15,489 

21,832 

16,204 

22,178 

18,019 

25;641 

18,828 

26,513 

17,578 

28,472 

17,517 

25,491 

16,145 

27,494 

14.419 

25,351 

14,490 

25,351 

15,119 

21,080 

15,710 

22,956 

17,218 

21  000 

From  the  preceding  table  it  appears  that  the  mortality  in  London  Avas 
great  from  1617  to  1750,  and  comparatively  low,  considering  the  increase  of 
population,  from  1751  to  1780. 

That  this  apparent  improvement  in  the  health  and  diminution  in  the 
mortality  of  London  was  not  due  to  inoculation  is  conclusively  shown  by 
the  following  statistics : 

Deaths  from  small-pox  in  London  during  fifteen  years  beginning 
from  1701  and  ending  with  1716,  before  the  introduction  of  inocu¬ 


lation . 22,219 

Deaths  from  small-pox  in  London  during  fifteen  years,  1717  to  1731, 

during  and  after  the  introduction  of  inoculation .  34,448 

Deaths  from  small-pox  in  London,  fifteen  years,  1732  to  1746,  dur¬ 
ing  inoculation . 29,462 

Deaths  from  small  pox  in  London,  fifteen  years,  1747JX)  1761,  dur¬ 
ing  inoculation . . 29,165 

Deaths  from  small  pox  in  London  during  fifteen  years,  1762  to  1776, 

during  inoculation . 36,276 


♦Observations,  etc.,  on  Small -pox,  p.  158,  p.  196. 


154 


Statistics  of  Small-Pox  and  Vaccination. 


During  the  preceding  fifteen  years  before  the  introduction  of  inoculation’ 
the  deaths  from  small-pox  reached  only  22,216,  whilst  after  its  introduction 
in  similar  periods  of  time  they  ranged  from  29,169  to  36,276,  the  highest 
number  occurring  in  the  last  series  of  fifteen  years. 


THE  ADVANTAGES  OF  COW-POX  INOCULATION  (VACCINA 
TION)  DEMONSTRATED  BY  OFFICIAL  RECORDS  AND  STA¬ 
TISTICS. 

In  order  to  place  this  subject  in  a  clear  and  impregnable  position,  we 
quote  from  official  reports  and  records. 

We  extract  the  following  from  the  valuable  Report  of  the  House  of  Com¬ 
mons  rpon  Hr.  Jenner’s  Claim. 

“As  a  comparison  between  this  new  practice  and  the  inoculated  small¬ 
pox,  forms  a  principal  consideration  in  the  present  inquiry,  some  facts  with 
regard  to  the  latter  engaged  the  attention  of  your  committee;  and  they 
have  inserted  in  the  appendix  statements  of  the  mortality  occasioned  by 
the  small-pox  in  forty-two  years  before  inoculation  was  practiced  in  Eng¬ 
land,  and  from  the  forty-two  years,  from  1731  to  1772,  the  result  of  which 
appears  to  be  an  increase  of  deaths,  amounting  to  seventeen  in  every  1,000, 
the  genei  al  average  giving  seventy-two  in  every  1000  during  the  first  forty- 
two  years,  and  eighty-seven  in  the  forty-two  years  ending  with  1772,  so  as 
to  make  t  he  whole  excess  of  deaths  in  that  latter  period  1742.  The  increase 
of  mortality  is  stated  by  another  witness  to  be  as  ninety-five  to  seventy, 
comparing  the  concluding  thirty  years  with  the  first  thirty  years  of  the  last 
century,  and  the  average  annual  mortality  from  small-pox  to  have  been 
latterly  about  2000;  for  although  individual  lives  are  certainly  preserved, 
iud  it  is  true  that  a  smaller  loss  happens  in  equal  numbers  who  undergo 
tin  small-pox  now  than  there  was  formerly,  yet  it  must  be  admitted,  that 
the  general  prevalence  of  inoculation  tends  to  spread  and  multiply  the  di¬ 
sease  itself;  of  which,  though  the  violence  be  much  abated  by  the  modern 
mode  of  treatment,  the  contagious  quality  remains  in  full  force.  It  de¬ 
serves  also  to  be  noticed,  that  the  deaths  under  the  inoculated  sort  of 
small-pox,  with  all  the  improvements  of  modern  experience,  are  not  incon¬ 
siderable.  It  is  stated  by  one  of  the  witnesses  at  about  one  in  every  300 
throughout  England  ;  by  another  as  about  one  in  every  100  in  London  ; 
while  the  loss  in  the  natural  small-pox  is  probably  not  less  than  one  in  six.” 

The  following  statement  was  subjoined  to  the  Report  of  the  House  of 
Commons,  illustrating  the  beneficial  effects  ot  vaccination. 

“For  this  purpose  we  shall  state  the  number  of  deaths  by  small-pox  from  the  bills  of 
mortality  of  parish  clerks  of  Loudon,  during  the  twelve  years  since  vaccination  was  in¬ 
troduced,  viz.,  from  January  1799,  to  January  1,  1811,  and  also  during  the  twelve  years 
immediately  preceding  the  vaccine  practice,  viz.,  from  January  1,  1787  to  January  1, 
1799.  But  in  order  to  judge  more  accurately,  we  shall  arrange  the  two  periods  of  twelve 
years  under  three  heads,  each  comprehending  four  years.  This  distribution  affords  the 
underwritten  tables : 


1.  Deaths  by  Small-pox  preceding 

cination  in  the  first  four  years: 

vac- 

2.  Deatlis  from  Small-pox,  during 
Vaccine  Practice  in  the  first  four  years 

the 

1 

In  1787  . . . 

2418 

1 

In  1799  . 

1111 

2 

In  1788 . 

1101 

9 

In  1800 . 

2409 

3 

In  1789 . 

2077 

3 

In  1801  ...  .... 

1401 

4 

In  1790  . 

1617 

4 

Iu  1802 .  . 

1579 

Total . . 

7213 

Total . 

6500 

Statistics  of  Small-Pox  and  Vaccination. 


155 


Deaths  from  Small-pox  in  the  second  four 
years  preceding  Vaccination: 

Deaths  from  Small-pox  in  the  second  four 
years  after  the  institution  of  the  Vaccine 
practice : 

1 

In  1791  .  . 

1747 

1 

In  1803 .  . 

1202 

2 

In  1792  . . . 

1568 

0 

In  1804...  . 

622 

3 

In  1793 

2382 

3 

I11  1805 _  _ 

1685 

4 

In  1794  .  .  . 

1913 

4 

In  1806  . 

1158 

Total  .  .... 

7610 

Total  

4667 

In  the  third  four  years  : 

In  the  third  four  years  : 

1 

In  1795 

1040 

1  In  1807  ...  . -  . . 

1297 

2 

In  1796  .... 

3548 

2|lu  1808 . 

2257 

3 

In  1797 . 

522 

3  In  1809  _ . 

1163 

4 

In  1798 .  . 

2237 

4 

In  1810  . 

1198 

Total .  . 

7547 

Total . .  . 

5915 

The  total  number  of  deaths  by  Small-pox  in  12  years  previous  to  inoculation _  22,170 

Ditto,  subsequent  to  vaccination  .... .  . . .  17,142 


The  total  number  of  deaths  by  Small-pox  in  12  years  previous  to  inoculation _  22,170 

Ditto,  subsequent  to  vaccination  .... .  . . .  17,142 

Decrease  . . .  . . . .  5,028 


From  the  preceding  statistics  it  appears  that  the  number  of  deaths  from 
small  pox  in  the  first  twelve  years  exceed  the  number  in  the  twelve  suc¬ 
ceeding  years  during  vaccination  by  5,028:  or  419  persons  per  annum 
fewer  for  twelve  years  died  since  than  before  vaccination. 

The  progressive  increase  of  the  population  during1' the  period  under  obser 
vation  should  also  be  taken  into  the  calculation.  The  absolute  increase  of 
the  population  of  England  from  1801  to  1811  was  one  million ,  six  thousand 
and  fifty  four,  or  about  eleven  in  100  5  or  setting  aside  the  increase  of  the 
army  and  navy,  the  population  of  England  increased  14^  per  cent ,  Wales 
and  Scotland  13  per  cent. 

The  following  statistics,  derived  from  authentic  sources,  illustrate  in  the 
clearest  manner  the  power  of  vaccination  and  re- vaccination  to  prevent 
small  pox  and  to  diminish  the  sum  of  disease,  suffering,  and  death,  and  to 
promote  the  longevity  of  the  human  race 

TABLE  SHOWING  THE  COMPARATIVE  MORTALITY  FROM  SMALL-POX  IN  LON- 
IN  DECENNIAL  PERIODS  BEFORE  THE  DISCOVERY  OF  INOCULATION  DUR¬ 
ING  THE  PRACTICE  OF  INOCULATION,  AND  UNDER  VACCINATION. 


♦Parliamentary  Return,  26th  April,  1853.  Vaccination,  its  Value  and  Alleged  Dangers,  etc.,  by  Edward 
Ballard  ;  London,  1868,  pp.  273  to  391 


156 


Statistics  of  Small- Pox  and  Vaccination. 


TABLE  SHOWING  THE  ANNUAL  DEATHS  FROM  ALL  CAUSES  AND  FROM 
SMALL-POX  IN  LONDON  FOR  DECENNIAL  PERIODS,  FROM  1751  TO 
1860.  (1). 


PERIODS. 

Average 

All  Causes. 

Annnal  Deaths 
Small-Pox. 

Small-Pox  Deaths 

per  1000  Deaths 
From  All  Causes. 

1751-60  . . . . 

20,872 

2,061 

100 

1761  60 . 

23,202 

2,445 

108 

1771-70 . . 

22,404 

2,204 

98 

1781-90  . 

19,516 

1,705 

8.7 

1791-1800 . 

20,213 

1,780 

88 

1801  10 . . 

19,582 

1,253 

64 

1811-20  . 

18,604 

793 

42 

1821  30 . ..... . 

21,645 

699 

32 

1831  40  . 

24,585 

573 

23 

1841  50  . 

52,217 

841 

16 

1851  60 . .  . 

61,047 

715 

11 

TABLE  SHOWING  THE  PROPORTION  OF  DEATHS  FROM  SMALL-POX  IN  PRAGUE, 
DURING  SEVEN  YEARS  PRIOR  TO  THE  INTRODUCTION  OF  A^ACCINATION, 
AND  TWENTY-FOUR  YEARS  SUBSEQUENT  TO  THE  INTRODUCTION  OF 
VACCINATION.  (2). 


Vears  1792-1806,  7  Years 

Prior  to  Introduction 
of  Vaccination. 

Years  1832-1855,  24  vears 

Subsequent  to  the  In¬ 
troduction  of  V  accination 

Proportion  to  Population  of  death  generally . 

1  to  32 

1  to  32i 

1  to  14,741^ 

1  to  457|- 

1  to  396§ 

1  to  12£ 

TABLE*  SHOWING  THE  NUMBER  OF  DEATHS  IN  ENGLAND  FROM  EACH  OF 
CERTAIN  ZYMOTIC  DISEASES  IN  EACH  OF  THE  TWENTY-THREE  YEARS 
FOR  WHICH  THE  RECORD  HAS  BEEN  MADE. 


YEARS. 

Scarlatina. 

Diphtheria. 

Measles. 

“Whooping 

Cough 

Small-Pox. 

E  ever. 

Diarrhoea, 
Dysentery 
and  Cholera. 

1838 . 

5802 

6514 

9107 

1 6268 

1K775 

3440 

1839  . . 

10325 

10937 

8165 

9]  3i 

1 5666 

1840  . . . . . 

19816 

9326 

6132 

10434 

17177 

4799 

1841 . . 

14161 

•••••• 

6894 

8099 

6368 

14846 

4198 

1 84*2 . . 

12807 

8742 

8091 

2715 

16201 

76°° 

1847 . 

14697 

8690 

926U 

4227 

30994 

15630  • 

1848. . . 

20502 

6867 

6862 

6003 

22037 

15604 

1 849 . . 

13111 

5464 

9615 

4645 

1 8347 

741  ^ 

1 850  . 

13370 

7080 

7770 

4666 

1 5375 

1851 . 

13594 

40 

9370 

7905 

6997 

17930 

18045 

1852 . 

18813 

74 

5846 

8022 

7320 

18641 

21754 

1853 . 

15653 

46 

4894 

11200 

3151 

18554 

20502 

1854  . 

18325 

203 

9277 

9770 

2808 

18893 

42092 

1855 . 

17128 

186 

7354 

10185 

2525 

16470 

15044 

1856 . 

13931 

229 

7124 

9225 

2277 

16182 

15912 

1857 . 

13919 

310 

5969 

10138 

3936 

19016 

24037 

1858 . 

25481 

4836 

9271 

11648 

6460 

17882 

16004  ' 

1859 . 

19907 

9587 

9548 

8976  - 

3848 

15877 

20597 

I860 . 

9681 

5212 

9557 

8555 

2749 

13012 

11185 

1861 . 

9077 

4517 

9055 

12309 

1320 

15440 

20999 

1862 . 

14834 

4903 

9800 

12272 

1628 

18721 

12667 

1863 . 

30475 

6507 

11349 

11275 

5964 

18017 

16801 

1864  . 

29700 

5404 

8323 

8570 

7684 

20106 

18368 

Note  (1)-— Report  of  tlie  Small-pox  and  Vaccination  Committee  of  the  Epidemiological  Society,  p .  41 . 
Handbook  of  Vaccination,  by  Edward  C.  Seaton,  M.  D.,  Medical  Inspector  to  the  Privy  Council  London 
18G8,  pp  422-424. 

Noto(2).— Mr.  Simon’s  Report  and  Papers  relating  to  the  History  and  Practice  of  Vaccination  1857  n 
162.  ’  1 
Vaccination,  etc.,  Edward  Ballard,  p.  378. 

*Eighift  Report  of  the  Medical  Officer  of  the  Privy  Council,  1865 ;  presented  pursuant  to  Act  of  Parlia¬ 
ment;  London,  130,  p.  38. 


157 


% 

Statistics  of  Small-Pox  and  Vaccination. 


TABLE  SHOWING  THE  ANNUAL  MORTALITY  FROM  SMALL-POX  IN  ENGLAND, 
WITH  THE  PROPORTION  OF  DEATHS  TO  POPULATION  AND  TOTAL  MOR¬ 
TALITY,  FROM  183S  TO  1865,  INCLUSIVE.* 


YEAR. 

Population. 

Deaths 
From  All 
Causes. 

Deaths 

From 

Small-pox. 

Deaths  from 
Small-pox  per 
One  Million  of 
Population. 

Deaths  from  Small¬ 
pox  per  1000 
Deaths  from  all 
Causes. 

Place  Occnpied  by 
Small-pox  in  the 
Order  of  Mortal¬ 
ity  in  the  Causes 
of  Deaths  in  Eng¬ 
land. 

1838  . 

15,312,256 

342,529 

16,268 

1,101 

47.96 

5th 

1839  . 

15,515,296 

338,979 

9,131 

604 

26.93 

10th 

1840  . 

15,721,029 

339,561 

10,434 

679 

29.00 

9th 

1841 . 

15,929,492 

343,849 

6,368 

408 

18.51 

14th 

1842  (1) . 

16,123,793 

349,519 

2,715 

172 

7.76 

25th 

1847  (1) . 

17,131,512 

420,304 

4,227 

246 

10,05 

22d 

1848  . 

17.340,492 

398,521 

6,903 

398 

17.32 

16  th 

1849  . 

17.552,020 

440.  °39 

4,644 

264 

10.53 

20th 

1850  . 

17,766,129 

368, a95 

4.665 

263 

12  90 

19th 

1851 . 

17.982,849 

395,396 

6,997 

396 

18.00 

15th 

1852  . 

18.205,627 

407,135 

7,320 

409 

18.28 

17th 

1853  . 

18,403,313 

421.097 

3,151 

174 

7.60 

26th 

1854  . 

18,618,760 

437,905 

2,808 

153 

6  49 

29th 

1855  . 

18,786,914 

425,703 

2,525 

136 

6.01 

34  th 

1856  . '. . 

19,045,187 

390,506 

2,277 

121 

5.90 

35th 

1857  . 

19,304,897 

419,815 

3,936 

206 

9.48 

24  th 

1858  . 

19,523,103 

449,656 

6,460 

335 

14  54 

18th 

1859  . 

19,746,000 

440,781 

3,848 

197 

8.84 

26th 

1860  . 

19,902,713 

422,721 

2,749 

140 

6.59 

35  th 

1861 . 

20,119,314 

435,114 

1,320 

66 

3.06 

46th 

1862  . 

20,336.467 

436,566 

1.628 

81 

3.77 

39th 

1863  . 

20,554,237 

473,837 

5,964 

293 

12.70 

21st 

1864  . 

20,772,308 

495,531 

7,684 

373 

15.64 

18th 

1865  . 

20,990,946 

490,909 

6.411 

309 

13.20 

21st 

Table  showing  the  annual  mortality  from  small-pox  in  England  and  in 
London  at  three  periods,  viz  : 

1.  Before  the  enactment  of  any  vaccination  laws. 

2.  After  vaccination  was  provided  gratuitously. 

3.  Since  vaccination  has  been  made  obligatory  by  statute.! 


DEATHS  FROM  SMALL-POX  IN  ENGLAND. 


« 


1.  Before  the  Enactment  of  any 
Vaccination  Laws. 

2.  Vaccination  Provided  Gratui 
tiously  but  not  made  Obligatory. 

3.  Vaccination  to  a  Certain  Extent 
made  Obligatory. 

Years. 

Deaths. 

Years. 

Deaths. 

Years.  • 

Deaths. 

1838  ..7  . 

16.268 

9,131 

10.434 

1841 .  * 

6.368 

2,715 

4,226 

6,903 

6,645 

6,666 

6,897 

7,320 

3,151 

1854 . 

2;  808 
2,525 
2,277 
3.936 
6,460 
3,808 
2,749 
1,320 
1.628 
5,964 

1839  . 

1842  (1) . 

1855 .  . 

1840 . . 

Average  annual  deaths 
from  Small-pox . 

1847  72) . 

1848  . 

1856  . 

1857  .  .  . 

1840 .  . 

1 85ft  . 

1850  . 

1859  .  . 

1851 . 

1800  . 

1852 . 

1861  . 

1853. . 

1865 . . 

1863  . 

11,944 

5,221 

3,351 

*  From  Reports  of  Registrar  General  of  England. 

(1).  From  1843  to  1846,  inclusive,  the  causes  of  deaths  wore  not  analyzed. by  the  Registrar  General. — Hand" 
book  of  Vaccination;  Edward  C.  Seaton,  M.  D.;  p.  422. 
t  Registrar  General’s  Report. 

Analysis  of  Heaths  from  1843  to  1846,  inclusive,  not  given  in  Registrar  Report  on  Vaccination  ;  by  Edward 
lallafd  j  p.  319 . 


158 


Statistics  of  Small-Pox  and  Vaccination. 


DEATHS  FROM  SMaLL-POX  IN  LONDON. 


1.  Before  the  Enactment  of  any 
Vaccination  Laws. 

2.  Vaccination  Provided  Gratui¬ 
tously,  but  not  made  Obligatory. 

3 .  Vaccination  to  a  Certain  Extent 
made  Obligatory. 

Years. 

Deaths. 

Years. 

Deaths. 

Years. 

Deaths. 

1838  . 

3.817 

634 

1,235 

1841 . 

1,053 

360 

438 

1,804 

909 

257 

955 

1,617 

518 

498 

1,066 

1,159 

211 

1854 . 

694 

1,033 

531 

156 

242 

1,158 

898 

217 

345 

2,012 

537 

646 

1,388 

1839 . 

1842 . 

1855 . 

1840 . 

1843 . 

1856 . 

1844 . 

1857 . . 

1845  . 

1858.  .. 

1846 . 

1859 . 

1847 . 

I860 . 

1848  . 

1861  .  . 

1849 .  ... 

1862 . 

1850  . 

1863 . . 

1851 . 

1864 . 

1852  . 

1865 . 

lL66 . 

A  verage  annual  deaths . . 

1.859 

826 

758 

The  diminution  of  the  deaths  from  small-pox  in  London,  during  the  pe¬ 
riod  specified  ( 1 838-1866,  29  ye  m  )  t<  ok  place  in  a  constantly  and  rapidly 
increasing  population.  In  the  years  1840-41,  the  annual  deaths  from 
small-pox  in  the  metropolis  was  616,  out  of  every  million  persons  living,  at 
all  ages;  from  1841  to  1850  there  were  in  the  mean  population  389  per  mil¬ 
lion  ;  from  1851  to  1861,  272  per  million. 


Table  Showing  the  Difference  between  the  Mortality  from  SmaH-Pox  in  Png 
land  and  Ireland ,  during  a  Period  in  which  there  was  no  Laic  Com¬ 
pelling  Vaccination ,  and  that  in  Countries  where  Vaccination  is  More  or 
Less  Compulsory  * 


Mortality  in  Various  Places  in  England,  Scotland 
and  Ireland  from  Small-pox,  as  Compared  with  the 
Total  Mortality  for  ten  years,  1850-1851. 

11 

Mortality  from  Small-pox,  in  Various  Countries  in 
Which  Vaccination  is  Directly  or  Indirectly  Com¬ 
pelled.  as  Compared  with  the  total  Mortality. 

PLACES. 

Deaths  from 
Small-pox  per 
1000.  Deaths 
from  All 
Causes. 

PLACES. 

Deaths  from 
Small  pox  per 
1000  Deaths 
from  All 
Cause,  s 

16.0 

Westphalia .  . 

6.0 

Birmingham . . . 

16  6 

Saxon v . . . 

8  33 

17.5 

Renish  Provinces . 

3.75 

18  0 

5.25 

19  4 

7.75 

21.0 

A.11  Prussia  .  . 

7.5 

24  2 

6.0 

25  0 

Trieste . . . 

5.15 

Greenock . . 

34 . 6 

Bohemia .  . . . 

2.0 

36.0 

Lombardy . 

2.0 

Dublin .  . 

25  66 

Venice . . 

2.2 

Cork  . . 

39.5 

Sweden . 

2.7 

35  0 

Bavaria  . 

4.0 

Limerick . 

41  0 

Connaught  ten  years,  ending  1841. .. 

60.0 

All  Ireland,  ditto  . 

49.0 

England  and  Wales  (eight  years) - 

21.9 

♦From  Parliamentary  Return.  April  20, 1853. 


Statistics  of  Smalt-Pox  and  Vaccination. 


159 


Mortality  of  Small-Pox  in  Copenhagen  for  a  Period  of  100  Years  before  Inoculation,  during 

Inoculation,  and  during  Vaccination,  1750-1850. 


YEAR. 


1750  ... 

1751  . 

1752  .... 

1753  . 

1754  . 

1755  .... 

1756  . 

1757.. .. 

1758  .... 

1759  . 

1760.  .. 

1761  .... 

1762  _ 

1763  . 

1764  .... 

1765  . 

1766  .... 

1767  .... 

1768  .... 

1769  .... 

1770  . 

1771  .... 

1772  . . . 

1773  .... 

1774  . 

1775  . 

1776  .... 

1777  . 

1778  .... 

1779  .... 

1780  . 

1781  .... 

1782  . 

1783  .... 

1784  .... 

1785  . 

1786  .... 

1787  . 

1788  .... 

1789  _ 

1790  _ 

1791  _ 

1792  ... 

1793  ... 

1794  _ 

1795. . .. 

1796  . 

1797.. .. 

1798.. .. 

1799.. .. 

1800.. .. 

1801 _ 


Remarks  and  Population . 


60000 


Inoculation  introduced..... 
Inoculation  Hospital  founded 


Inoculation  Hospital  closed. 


Died  of 
Small-Pox. 


1802 


70495 

Inoculation  Establishment  in 
troduced . ! 


Inoculation  Establishment 
closed . 


83604 


Vaccination  first  introduced, 

91631  . . 2 

Vaccination  Establishment 
erected . 


1457 

80 

113 

53 

9 

1117 

125 

13 

13 

1079 

118 

4 

7 
167 
480 

138 
42 

6 

27 

1219 

22 

8 

22 

190 

116 

276 

86 

7 

270 

283 

98 

174 

332 

123 

77 

427 

193 

136 

185 

323 

140 

297 

155 

139 
452 
248 
357 
423 
386 

45 

35 

486 

73 


1803 . ■ 


YExVR. 


1804.. 

1805  . 

1806  . 

1807  . 

1808  . 

1809 . . 

1810.. 
1811. . 
1812  . 
1813  .. 

1814.. . 
1815  .. 

1816.. . 
1817  .. 
1818... 

1819  .. 

1820  . . 
1821... 
1822. . . 

1823.. . 

1824  .. 

1825  .. 

1826.. . 

1827  .. 

1828  ., 

1829. . . 

1830. . . 
1831  . . 

1832.. . 

1833  . 

1834  .. 

1835.. . 
1836.  . 


1837. . 

1838.. 

1839.. 

1840  . 

1841  . 

1842  . 

1843. . 

1844. . 


Commission  recognize  pro 
tective  power  of  vacci¬ 
nation  . 


■:::! 


! 


Remarks  and  Population. 


Died  of 
Small-Pox. 


Decree  ordering  vaccination 

promulgated  . 

100975 


Vaccination  placed  under 
control  Board  of  Health. 


Revaccination  general .  ... 
119292 

119591 

Revaccination  ordered  for  the 
army . 


1845  . 

1846  . 

1847  _ 

1848  . 

1849  . 

1850  . 


Revaccination  ordered  for  the 

navy . 

126787 


129695 


13 

5 

5 

2 

46 

5 


0 

0 

0 

0 

0 

0 

0 

0 

0 

0 

0 

41 

12 

29 

4 

1 

29 

3 

0 

3 

19 

26 

434 

81 

1 

o 

0 

2 

0 

35 

111 

83 

7 

0 

0 

o 

7 

0 


Mr.  Simon’s  Report  (Papers  Relating  to  the  History  and  Practice  of 
Vaccination,  p.  171.  Vaccination,  Edward  Ballard,  M.  D.,  p.  375). 


160 


Statistics  of  Small-Pox  and  Vaccination. 


Table  Showing  for  Several  Centuries  the  Death  Rate  from  Small-Pox  during  a 
Period  prior  to  the  Introduction  of  Vaccination  and  since  the  Introduction 
of  Vaccination.* 


Sums  of  Years  Res¬ 
pecting  Which  Par 
ticularsare  Given. 


1777- 

1777- 

1777- 

1777- 

1777- 

1777- 

1777- 

1777- 

1777- 

1777- 

1787- 


-1806 

-1806 

-1807 

-1806 

-1806 

-1806 

-1806 

-1806 

-1806 

-1806 

-1806 


1776-1780 

1780 

1780 

1776-1780 

1776-1780 

1776-1780 

1781-1805 

1776-1780 

1780 

1774-1801 

1751.1800 


and  1807- 
and  1807- 
and  1806- 
and  1807- 
and  1807- 
and  1807- 
and  1807- 
aml  1807- 
and  1807- 
and  1807- 
and  1807- 
1817- 
1817- 
1817- 
1831- 
and  1810 
and  1616- 
and  1816- 
and  1810- 
and  1816- 
and  1816- 
and  1810- 
and  1816- 
and  1810- 
1810- 
and  1810- 
and  1801- 


TERRITORY. 


1850  Lower  Austria. 

1850  Upper  Austria  and  Saltzberg. 
1850  Styria. 

-1850  Illyria. 

-1850  Trieste. 

-1850  Tyrol  and  Voralberg . 

-1850  Bohemia . 

-1850  Moravia . 

-1850  Gallicia . 

-1850  Austrian  Silesia  . 

-1850  Bulkorania . 

-1850  Dalmatia . 

-1850  Lombardy  . 

-1850  Venice .  . . 

•1850  Military  Frontiers  . 

1850  Prussia  (Eastern  Provinces) . . 
•1850  Prussia  (Western  Provinces) . 

■1850  Posen  . . 

1850  Brandenburgh . 

1850  Westphalia . 

1850  Rhenish  Provinces . 

1850  Berlin  . 

1850  Prussian  Saxony . 

1850  Pomerania . 

1850  Prussian  Silesia . 

■1850  Sweden . 

1850  Copenhagen . 


Approximate  Ave'rage  Annual 
Death  Rate  per  Million  of 
Living  Population. 


Befoie  Intro¬ 
duction  of 
Vaccination. 

After  Intro- 
d  u  c  t  i  o  n  of 
V  accination. 

2,484 

340 

1,421 

501 

1,052 

446 

518 

244 

14.046 

182 

911 

170 

2,174 

215 

5  402 

255 

1,194 

676 

5,812 

198 

3,527 

516 

86 

87 

70 

288 

3,321 

556 

2,272 

356 

1,911 

743 

2,181 

181 

2,613 

114 

908 

90 

3,422 

176 

719 

170 

1,774 

130 

310 

2,050 

158 

3,128 

286 

Table  Showing  the  Relative  Fatality  of  Small-Pox  When  it  Affects  the  Un- 

vacinated  and  Vaccinated .f 


Places  and  Times  of  Observation. 


France,  1816-41 . 

Quebec,  1819-20  . 

Philadelphia,  1825  . 

Canton  Vand,  1828-9 . 

Durkehmen,  1828-9 . 

Verona,  1828-39 . 

Milan,  1830-51 . 

Boston,  1831-33  . 

Wirtemberg,  1831$ — 5$ . 

Carniola,  1834-5  . 

Vienna  Hospital,  1834 . 

Carinthia.  1834-5 . 

Adriatic,  1835  . 

Lower  Austria,  1835 . 

Bohemia,  1835-1855 . 

Gallicia,  1836  . 

Dalmatia,  1836 .  . 

London  Small  pox  Hospital,  1836-56 

Vienna  Hospital,  1837-66 . . 

Kiel.  1852-3 . 

Wirtemberg,  no  date . 

Malta,  no  date  . 

Epidemiological  Society  returns.  .. 


Total  Number 
of  Cases  Ob¬ 
served, 


Death  Rate  per  100  Cases. 


Among  Tnrac-  Among  the 
cinated.  Vaccinated. 


16,397 

2 

140 

5,838 

134 

909 

10,240 

220 

1,442 

412 

360 

1,626 

1,002 

2,287 

15,640 

1,059 

723 

9,000 

6,213 

218 

6,258 

7,570 

4,624 


16$ 

27 

60 

24 

18  4-5 
46$ 

38$ 

53  4-5 
27$ 

1-6$ 

51$ 

14$ 

15  1-5 

25  4-6 

29  4-5 
23$ 

19$ 

35 

30 

19 

38  9-10 
21  7-100 
19  7-10 


1 

0 

2  1-6 
0 

5f 

7$ 

2  1-9 
7  1-10 

4  2-5 
12$ 

i 

2  4-5 
11$ 

5 

5  1-7 

8$ 

7 

5 

6 
3$ 

4  2-10 
2  9-10 


*Mr.  Simon’s  Report ;  Papers  relating  to  the  History  and  Practice  of  Vaccination,  1857,  p.  23. 
fPapers  relating  to  the  History  and  Practice  of  Vaccination,  p.  27. 


161 


Statistics  of  Small-Pox  and  Vaccination. 


The  statistics  relating  to  the  effects  of  vaccination  in  reducing  in  a  mark¬ 
ed  manner  the  mortality  from  small-pox  in  various  countries,  will  be  still 
farther  extended  and  enlarged,  under  the  subsequent  division  of  this  inquiry 
relative  to  the  history  of  the  cow-pox,  and  the  introduction  of  vaccination  in¬ 
to  the  various  states  of  the  American  Union. 

The  following  conclusions  and  general  results  may  be  deduced  from  the 
preceding  statistics. 

1.  In  every  country  in  which  the  practice  of  vaccination  has  been  adopted 
Here  has  been  a  marked  reduction  of  the  mortality  from  small-pox. 

In  times  preceding  the  introduction  of  vaccination,  small  pox  was  the 
terror  of  princes  and  the  fierce  unconquerable  slayer  of  the  people;  and 
although  its  nature  has  lost  none  of  its  cruel  and  destructive  attributes,  it 
has  been  so  effectually  guarded  that  none  need  fear  its  attack,  but  those 
who  neglect  vaccination. 

It  is  estimated  that  prior  to  the  commencement  of  this  century,  out  of 
every  million  of  the  population  of  England,  3001)  persons  annually  fell  vic¬ 
tims  to  small  pox  ;  during  tiie  ten  years  1851,  to  1860,  the  mean  population 
of  England  and  Wales  was  18,996,916  persons;  during  the  ten  years,  42,071 
individuals  died  of  small  pox,  which  is  in  a  ratio  of  2314  per  million  of 
population  for  this  whole  period,  or  only  221.  4  on  the  average  annually  ; 
therefore  small-pox  has  been  more  than  ten  times  less  fatal  to  the  people  of 
England,  than  it  was  when  vaccination  was  not  known. 

2.  The  practice  of  inoculation  promoted  the  spread  of  small-pox  and  increas¬ 
ed  the  mortality  from  this  aisease. 

In  London,  during  the  latter  halt  of  the  seventeenth  century,  when  in¬ 
oculation  was  not  practiced,  the  death-rate  from  small- pox  ranged  from 
thirty-six  to  seventy-four  per  101)0  of  all  the  deaths  that  took  place,  the 
mean  being  fifty-six  ;  during  the  second  or  inoculation  epoch,  it  ranged  from 
eighty -seven  to  108  per  1000,  the  mean  being  ninety-six;  and  during  the 
third  or  vacciation  epoch,  it  has  ranged  from  twelve  to  forty-two  per  1000, 
the.  mean  being  twenty-five. 

In  Copenhagen  in  1750,  with  a  population  of  60,000,  1457  deaths  occurred 
from  small  pox  ;  in  1755,  1117  deaths;  in  1759,  1079  deaths;  in  1769,  with  a 
population  of  70,000,  small-pox  occcasioned  1219  deaths. 

Vaccination  was  introduced  into  Denmark,  in  the  year  1801;  and  during 
the  ten  years  preceding  there  occurred  in  Copenhagen  alone  2516  deaths 
from  small-pox,  which  becoming  more  prevalent  in  1801,  carried  off  in  that 
year  486  of  the  inhabitants  of  the  city.  From  1802  to  1810  inclusive,  in  the 
course  of  the  nine  years  succeeding  the  introduction  of  vaccination, small¬ 
pox  occasioned  only  158  deaths;  and  from  this  latter  year  until  1824,  al¬ 
though  the  population  had  risen  to  above  100,000  not  a  single  death  from 
small-pox  was  recorded. 

Vaccination  appears  to  have  been  introduced  in  Prussia  in  1801,  and  in 
1803,  inoculation  for  small-pox ,  was  prohibited  ;  before  the  introduction  of 
vaccination,  40,000  persons  were  said  to  die  annually  of  small  pox  within 
the  Prussian  domains;  in  1817,  notwithstanding  an  extension  of  tenitory, 
out  of  306,  728  deaths  only  2940,  were  occasioned  by  small-pox  ;  and  this 
result  was  clearly  due  to  the  extensive  practice  of  vaccination,  the  number 
of  vaccinations  far  exceeding  the  number  of  births. 

In  the  department  of  Breslau,  in  1818,  out  of  a  population  of  510,617  per¬ 
sons,  17,629  were  successfully  vaccinated  ;  and  although  during  this  year 
small-pox  was  introduced  at  nine  different  places,  only  twenty-eight  per¬ 
sons  took  the  disease,  and  only  six  persons  died  of  it. 

Vaccination  was  introduced  in  the  principality  of  Ansprach,  in  Bavaria, 
in  1801,  and  in  1807  regulations  for  public  vaccination  and  the  suppression 


m 


Statistics  of  Small-Pox  and  Vaccination. 


of  small  pox  was  promulgated  by  the  Government,  which  were  rendered  still 
more  stringent  in  1808.  In  this  principality,  with  a  population  of  2(30,406 
individuals,  three  perished  from  small-pox  during  the  years  1797-98-99,  on 
an  average  an  annual  number  of  500  persons,  and  in  the  single  year  1800, 
no  less  than  1609  persons.  In  the  year  1807,  500  cases  and  fifty  deaths 
from  small-pox  occurred.  In  this  year  under  the  new  regulations,  3 i, 880 
persons  were  vaccinated,  and  during  this  and  the  subsequent  years,  al¬ 
together  141,755,  persons  underwent  the  operation. 

In  the  year  1808,  only  eight  cases  of  small- pox,  and  one  death  occurred  ; 
in  the  year  1809,  only  eleven  cases  and  four  deaths ;  and  from  this  time  to 
1818,  only  four  cases,  every  one  of  which  recovered.  And  yet  during  these 
three  years  small-pox  wras  prevailing  epidemically  in  the  adjoining  kingdoms 
of  Wurtemburg,  where  vaccination  was  not  enjoined  until  1818. 

According  to  Mr.  Hendricks:*  in  Sweden,  from  the  year  1749  to  1801,  the 
proportion  of  small  pox  varied  from  1.2  per  cent  in  1786,  to  25.16  per  cent 
in  1779  ;  in  three  years  prior  to  the  practice  of  vaccination,  the 
small-pox  deaths  was  under  1  per  cent  of  all  deaths  in  no  one  year ;  from 
5  and  under  10  per  cent  of  all  deaths  in  twenty-two  years  ;  10  to  20  per 
cent  in  seventeen  years  ;  and  20  per  cent  in  two  years.  During  the  vac¬ 
cination  period,  from  1802  to  1855,  the  proportion  of  deaths  from  small¬ 
pox  varied  from  no  deaths  in  1846,  to  343  per  cent  of  the  deaths  from  all 
causes  is  1881.  During  this  the  vaccination  period,  the  small-pox  deaths 
were  under  1  per  cent,  of  all  deaths  in  thirty-three  years,  from  1  and  un¬ 
der  2  per  cent  in  nine  years  2  per  cent  and  under  3  per  cent  in  ten  years; 
3  per  cent  and  under  4  per  cent  in  two  years,  over  4  per  cent  in  no  one 
year. 

It  is  also  shown  by  the  statistics  of  a  large  number  of  European  States, 
collected  by  Dr.  Seaton  from  the  statistics  of  the  Epidemiological  Society 
(recalculated  by  Mr.  Simon),  that  the  mortality  from  small-pox  per  million 
of  population  has  been  vastly  reduced  since  the  introduction  of  vaccination. 
Thus  the  small  pox  mortality  in  Trieste  during  the  vaccination  period  has 
been  seventy-five  times  less  than  it  has  been  before,  in  Moravia  twenty-one 
times  less,  in  Silesia  twenty-nine  times  less,  in  Westphalia,  twenty-five 
times  less,  iu  Berlin  nineteen  times  less,  in  Sweden  thirteen  times  less,  in 
Lower  Austria  seven  times  less,  and,  in  Copenhagen  eleven  times  less. 

3.  The  mortality  from  small-pox  has  been  least  in  those  States,  and  places 
where  the  most  complete  arrangements  have  been  in  force  for  bringing  the  entire 
population  under  the  protective  influence  of  the  vaccine  disease  ;  and  when  in  the 
same  county  or  localities  the  regulations  for  the  enforcement  of  public  vaccination 
have  been  more  strict  at  one  period  than  at  another ,  and  when  this  has  been 
more  actively  carried  out  at  one  time  than  at  another ,  the  mortality  of  the  pop¬ 
ulation  from  small-pox  has  receded  as  the  vaccination  of  the  masses  has  been 
more  perfectly  ensured. 

4.  The  evidence  is  conclusive  that  the  vast  majority  of  mankind  may ,  by  a  sin¬ 
gle  properly  perfected  vaccination ,  be  rendered  wholly  unsusceptible  of  any  sub¬ 
sequent  action  of  the  variolous  poison  ;  and  that  in  the  m  inority,  where  suscepti¬ 
bility  to  small-pox  infection  has  not  been  entirely  exhausted  by  the  vaccine  pro¬ 
cess,  the  disease  will  with  rare  exceptions  be  so  modified  as  to  be  but  rarely  at¬ 
tended  with  severe  or  fatal  effects. 

Vaccination,  without  endangering  the  life  of  the  individual  submitted  to 
it,  and  without  diffusing  any  infection,  entirely  and  permanently  exhausts 
the  susceptibility  to  small-pox  in  the  vast  majority  of  those  in  whom  it 
has  been  properly  performed ;  but  leaves  an  undetermined  proportion  still 


*  Vital  Statistics  of  Sweden  from  1749  to  1856,— Statistical  Journal,  1862,  Vol.  25,  p.  142. 


Statistics  of  Small-Pox  and  Vaccination. 


163 


subject  in  a  greater  or  less  degree  to  the  action  of  the  variolous  poison.  In 
those  where  susceptibility  has  been  only  partially  destroyed,  the  action  of 
the  variolous  infection  may  be  manifested  at  any  period,  from  a  few  weeks 
or  months  to  any  number  of  years,  after  the  performance  of  the  vaccination  ; 
but  it  is  most  frequently  not  manifested  till  after  puberty,  and  when  man¬ 
ifested  before  puberty  is  generally  inconsiderable  in  degree  and  only  quite 
exceptionally  fatal.  The  degree  of  severity  which  post-vaccinal  small-pox 
may  manifest  after  purbety  is  chiefly  determined  by  the  perfection  of 
character  and  sufficiency  of  amount  of  the  vaccination  that  has  been  per¬ 
formed;  even  when  the  vaccination  has  been  the  most  imperfect,  leaving 
but  a  single  mark  of  indifferent  character,  the  disease  is  still  in  most  in¬ 
stances  modified  in  its  course,  and  is  not  fatal  in  one  third  the  proportion 
of  cases  in  which  natural  small  pox  is  fatal ;  but  when  the  vaccination  has 
been  done  in  the  best  manner,  the  modification  is  so  great  and  so  general 
that  the  proportion  of  deaths  to  attacks  is  scarcely  more  than  the  seventieth 
part  of  that  which  occurs  in  the  natural  disease.  It  is  therefore  a  matter 
of  vital  importance  that  the  vaccination  should  always  be  done  in  the  best 
known  manner.  * 

5.  Revaccination  should  be  performed  on  all  persons  after  puberty  •  and  in 
all  cases  irrespective  of  the  age  (before  or  after  puberty),  when  the  vaccination 
has  been  imperfect  in  character ,  spurious ,  irregular ,  or  disturbed  in  its  normal 
course. 

After  successful  revacci nation,  small-pox,  even  of  the  most  slight  or  mod¬ 
ified  form,  is  rarely  met  with.  Thomas  Heim  found  that  in  five  years  there 
occurred  among  14,381  revaccinated  soldiers  in  Wurtemberg  not  one  in¬ 
stance  of  varioloid,  and  among  30,000  revaccinated  persons  in  civil  practice 
only  two  cases  of  varioloid  occurred,  although  during  three  years  small  pox 
had  prevailed  in  344  localities,  producing  1,673  cases  of  modified  and  un¬ 
modified  small  pox  among  the  not  revaccinated  and  in  part  not  vaccinated 
population  of  363,298  persons  in  those  places  in  which  it  had  prevailed. 

In  the  Prussian  Army,  since  the  introduction  of  systematic  revaccination 
in  1839,  the  cases  reported  as  “  varioloid,”  and,  still  more,  those  called 
u  variola,”  have  been  nearly  all  of  them  among  that  portion  of  recruits 
whose  turn  for  revaccination  had  never  come,  on  whom  revaccination  had 
not  been  successful,  or  who  were  incubating  small-pox  when  they  were  re- 
vaccinated  ;  in  the  twenty  years  which  immediately  succeeded  the  adoption 
of  this  system  there  occurred  altogether  but  forty  deaths  from  small-pox 
in  this  large  army — or  an  average  of  two  deaths  per  annum — only  four  of 
the  entire  forty  being  in  persons  said  to  have  been  successfully  revaccin- 
ated. 

In  the  Bavarian  Army,  in  which  there  had  been  compulsory  revaccina¬ 
tion  since  1843,  there  had  not  from  that  date  up  to  the  time  of  a  report 
made  to  the  Minister  of  War,  in  1855,  been  a  single  case  of  unmodified 
small  pox,  and  only  a  very  few  cases  of  modified  small  pox  without  any 
deaths. — Simon’s  Papers  Relating  to  Vaccination,  pp.  35-36.  Seaton’s  Hand- 
Book  of  Vaccination ,  pp.  268-273. 

Mr.  Marson  has  recorded  the  fact,  that  during  the  period  of  his  connec¬ 
tion  .with  the  Small-pox  Hospital,  not  one  of  the  nurses  or  servants  had 
taken  the  small  pox  during  her  residence  there,  each  one  of  them  who 
had  not  already  had  small  pox  having  bee  t  carefully  re-vaccinated 
before  being  allowed  to  enter  on  her  duties  (Medina  Chirurgical  Trans,  vol. 
36).  Mr.  Marson  had  been  connected  with  the  Small-pox  Hospital  above 

*  The  work  of  Dr.  Edward  C  Seaton  Medical  Inspector  to  the  Privy  Council  (Hand  book  of  Vaccina¬ 
tion),  will  prove  of  value  to  every  sanitarian  and  practitioner  of  medicine  as  if  contains  all  the  necessary  de¬ 
tails. 


164 


History  of  Cow-Fox  Inoculation  in  England . 


seventeen  years  when  lie  made  the  preceding  statement,  which,  according 
to  Dr.  Edward  C.  Seaton,  “  holds  equally  good  now  after  a  connection  of 
more  than  thirty-two  years.’7 

From  the  preceding  considerations  the  important  practical  rule  has  been 
chosen  :  That  every  person  should  be  re-vaccinated  about  the  age  of 
puberty,  for  the  age  of  most  danger  from  postvaccinal  smallpox  is  from 
fifteen  to  twenty-five;  on  the  other  hand,  when  there  is  any  unusual  risk 
of  small-pox,  as  in  localities  in  which  the  disease  is  prevailing  re  vaccina¬ 
tion  may  be  and  should  be  performed  at  any  period  of  life  after  birth. 

6.  During  the  nineteenth  century  the  application  of  steam  to  the  rapid  trans¬ 
portation  of  human  beings  and  merchandise ,  has  furnished  the  most  important 
and  essential  condition  for  the  rapid  and  con  tinuous  spread  of  small-pox  over 
the  entire  face  of  the  habitable  globe  ;  and  but  for  the  discovery  of  vaccination 
by  Edward  Jenner ,  this  pestilence  would  have  reigned  without  intermission  in 
all  commercial  centres  and  been  perpetually  propagated  along  all  the  lines  of 
human  travel  and  intercourse. 

Fortunately  for  mankind,  the  applica  t  ion  of  steam  to  the  wants  of  mankind 
was  preceded,  by  the  discovery  and  diffusion  of  the  process  of  vaccination. 

f 


OUTLINE  OF  THE  INTRODUCTION  OF  COW-POX  INOCULA¬ 
TION  INTO  VARIOUS  COUNTRIES,  AND  ESPECIALLY  THE 
NEW  ENGLAND,  MIDDLE  AND  SOUTHERN  STATES  OF 
THE  UNITED  STATES  OF  NORTH  AMERICA. 

The  following  observations,  facts  and  statistics  will  show  that  the  most 
powerful  and  impregnable  argument  in  behalf  of  vaccination  is  furnished 
by  the  simple  historical  narrative  of  the  Introduction  of  Cow-Pox  In¬ 
oculation  in  Various  Countries.  The  labor  necessarily  endured  in 
the  tedious  search  through  the  records  of  medical  science,  and  the  still 
greater  labor  of  analysis,  comparison  and  synthesis,  has  received  the  great 
and  inestimable  reward  of  establishing,  by  numberless  facts,  the  value  of 
vaccination  in  preventing'and  modifying  small-pox,  and  in  vastly  diminish¬ 
ing  the  sufferings  and  mortality  of  the  human  race. 


HISTORY  OF  COW-POX  INOCULATION  IN  ENGLAND. 

It  does  not  appear  that  the  anti- variolous  power  of  cow-pock  was  gen¬ 
erally  taken  notice  of  in  England  until  after  the  introduction  of  small  pox 
inoculation  ;  before  that  time  a  knowledge  of  it  was  chiefly  confined  to 
cow  doctors,  farmers,  etc.,  who  did  all  in  their  power  to  keep  its  existence 
a  profound  secret,  lest  it  should  hurt  the  character  of  their  milk.  When 
inoculation  for  small-pox  was  first  practiced  in  England,  most  of  the  prac¬ 
titioners  engaged  in  it  frequently  experienced  disappointment  in  communi¬ 
cating  that  disease  by  inoculation  or  otherwise,  and  they  constantly  found 
that  those  who  thus  resisted  the  infection  had  previously  had  the  cow-pock. 
About  one  hundred  and  twenty  four  years  ago,  three  surgeons,  Messrs. 
Fewster,  Grove  and  the  celebrated  Sutton,  formed  a  connection  for  the 
purpose  of  inoculating  for  the  small-pox. 

In  their  practice,  which  became  very  extensive,  they  found  that  a  great 
number  of  patients  could  not  be  infected,  notwithstanding  repeated  expos¬ 
ure  under  the  most  favorable  circumstances.  At  length  the  cause  of  the 


History  of  Cow-Fox  Inoculation  in  England. 


165 


failure  was  discovered,  by  the  case  of  a  farmer  whom  they  could  not  infect 
with  the  small  pox,  though  he  assured  them  he  never  had  the  disease,  but 
told  them  he  had  had  the  cow-pox.  This  fact  incited  the  gentlemen  to  in¬ 
quire  into  the  particulars  of  these  cases  in  which  they  could  not  communi¬ 
cate  the  small  pox,  and  they  found  that  all  the  patients  who  resisted  the 
infection  of  the  disease  had  labored  under  the  cow-pox  at  some  period  or 
other  of  their  lives.  The  result  of  their  observations  on  this  head,  in  an 
ample  experience,  during  many  subsequent  years,  was  invariably  the  same. 
And  many  other  gentlemen,  extensively  engaged  in  variolous  inoculation, 
have  since  discovered  that  their  want  of  success  in  infecting  patients  with 
small-pox  proceeded  from  the  same  cause. 

In  the  year  1780,  a  young  worn  am  who  some  years  before  had  taken  the  cow- 
pox  while  milking  cows,  being  desirous  to  know  whether  this  circumstance 
would  secure  her  from  the  small  pox,  went  to  the  Small  pox  Hospital  in  Lon¬ 
don.  where  she  was  inoculated  and  exposed  in  all  possible  ways  to  the  conta¬ 
gion,  yet  did  not  take  the  disease.  A  man  who  had  had  the  cow-pox  sev¬ 
eral  years  before,  went  to  the  Hospital,  and  was  inoculated  for  small-pox; 
he  remained  there  in  the  very  midst  of  contagion  for  several  weeks,  but  did 
not  take  that  disease.  About  one  hundred  and  thirty-two  years  ago,  a 
farmer  who  lived  in  Wiltshire,  when  he  was  going  to  London,  being  asked 
whether  he  was  not  afraid  of  the  small-pox,  replied — no — for  he  had  had 
the  cow-pox. 

In  a  letter  dated  Axminster,  April  12,  1802,  from  Mr.  Nicholas  Bragge 
to  Sir  William  Elford,  Baronet,  we  find  the  following  communication  :  “It 
is  now  more  than  thirty  years  ago  that  I  first  made  experiments,  and  proved 
that  the  vaccine  disase  was  a  preventive  against  the  small  pox,  and  it  is, 
I  believe,  more  than  twenty  years  ago,  that,  through  the  Rev.  Hermen 
Drew,  I  acquainted  Sir  George  Baker,  Baronet,  with  the  observations  and 
experiments  I  had  made.  It  is  twenty  years  ago  that  Mrs.  Kendall,  the 
wife  of  a  vegetable  farmer  in  the  parish  of  Whitechurcli,  near  Lyme,  in 
Dorsetshire,  inoculated  herself  ai  d  three  or  four  children  for  it;  and  these 
children ,  who  have  long  since  arrived  at  manhood ,  have  inoculated  their  friends 
and  neighbors  whenever  an  opportunity  has  offered P  Many  communications 
of  a  similar  nature  may  be  found  in  the  Report  of  the  Committee  of  the 
House  of  Commons  on  Dr.  Jenner’s  Claims. 

In  the  year  1767,  a  butcher,  near  Bridgeport,  aged  twenty,  being  informed 
that  if  he  would  allow  himself  to  be  inoculated  with  cow-pock,  it  would 
preserve  him  ever  after  from  taking  the  small  pox,  with  which  he  had  not 
been  previously  affected,  was  accordingly  inoculated  by  a  needle  in  two  or 
three  places  on  the  hand.  In  eight  days  the  parts  inflamed,  the  hand 
swelled,  headache  and  other  symptoms  of  fever  came  on.  He  was  after 
wards  inoculated  for  small  pox  several  times,  and  exposed  in  every  way  to 
it,  but  did  not  take  the  disease. 

Mr.  Benjamin  Jesty,  farmer  of  Downslmy,  in  the  Isle  of  Purbeck,  ap¬ 
peared  at  the  Vaccine  Pock  Institution,  London,  in  August  1805,  when 
he  afforded  satisfactory  evidence  of  his  having  vaccinated  his  wife  and  two 
sons,  Robert  and  Benjamin,  in  the  year  1774,  who  were  thereby  rendered 
unsusceptible  of  small-pox,  as  appeared  by  the  exposure  of  all  the  three 
parties  to  that  disorder  frequently  during  thirty-one  years,  and  from  the 
inoculation  of  the  two  sons  for  small-pox  nineteen  years  before.  He  was 
led  to  undertake  this  novel  practice  in  1774,  from  knowing  the  common 
opinion  of  the  country  ever  since  he  was  a  boy,  that  persons  who  had  gone 
through  the  cow-pock  were  unsusceptible  of  small  pox,  from  himself  being 
rendered  incapable  of  taking  that  disease,  having  gone  through  the  cow-pox 
many  years  before;  and  from  having  known  many  individuals,  who,  after 


166 


History  of  Cow-Fox  Inoculation  in  England. 


tlie  cow-pock,  could  not  be  infected  with  small-pox.  During  their  visit  to 
London,  Mr.  Jesty  and  son  willingly  submitted  publicly  to  inoculation — the 
former  with  cow-pock,  and  the  latter  with  small-pox — in  the  most  rigorous 
manner,  but  neither  could  be  infected. 

Mr.  White,  of  Bath,  in  a  letter  to  Mr.  Greaser,  of  that  city,  mentions  the 
case  of  a  laboring  man  who,  about  the  year  1780, being  then  a  farmer’s  boy, 
had  the  disease  communicated  to  him  in  a  frolic,  upon  a  small  scratch  in 
his  hand,  by  one  of  his  fellow  servants,  who  had  gotten  it  by  milking  a 
cow.  He  has  since  been  repeatedly  inoculated  without  effect ;  his  family 
has  had  the  inoculated  small  pox  around  him,  and  he  has  more  than  once 
been  exposed  to  the  most  malignant  species  of  that  disease  without  any  sort 
of  effect  being  produced  upon  him. 

About  the  year  1782,  when  Dr.  Archer  was  physician  to  the  Hospital  for 
Small-pox  Inoculation,  Catherine  Wilkins,  from  Crichlade,  Wittshire,  who 
had  had  the  cow-pock,  in  consequence  of  milking  cows,  came  to  her  brother 
in  London,  who,  being  desirous  of  ascertaining  whether  this  circumstance 
could  be  depended  upon  as  preventive  of  the  small-pox,  sent  her  to  the 
hospital  for  inoculation,  where  she  was  inoculated  with  variolous  matter 
by  the  doctor,  against  which,  however,  she  v^is  proof. 

In  the  year  1787,  when  there  was  a  general  inoculation  for  the  small  pox 
in  Wincaunton,  in  Somersetshire,  a  young  woman  was  twice  inoculated 
without  effect.  The  failure  was  attributed  to  having  had  the  cow-pox  some 
years  before. 

The  failure  so  often  remarked  of  communicating  small  pox  to  blacksmiths 
by  inoculation,  must  have  arisen  from  them  previously  having  been  in¬ 
fected  with  the  equine  pock,  in  dressing  the  horses’  heels  laboring  under 
that  complaint. 

The  first  allusion  to  cow-pock  on  record  is  noticed  bj  Dr.  Jenner,  in  a 
letter  to  Mr.  Bing,  “  When  the  Duchess  of  Cleveland,”  said  he,  u  was 
taunted  by  some  of  her  companions,  that  she  might  have  to  deplore  the 
loss  of  that  beauty  which  was  then  her  boast,  (the  small  pox  at  that  time 
was  raging  in  London)  she  made  a  reply  to  this  effect,  that  she  had  no  fear 
about  the  matter,  for  she  had  had  a  disorder,  which  would  prevent  her 
from  ever  catching  the  small  pox.”  The  author  from  whence  this  intelli¬ 
gence  was  derived,  could  not  be  recollected,  but  Dr.  Jenner  was  disposed 
to  believe  that  it  alludes  to  cow-pock. 

Jenner,  in  his  first  treatise,  besides  referring  to  cases  in  which  the  dis¬ 
ease  had  been  accidentally  transferred  to  various  persons  at  different  pe¬ 
riods  long  past,  mentions  it  as  having  been  specially  noted  in  the  Glouces¬ 
tershire  dairies  in  1770,  1780,  1782,  1791  and  1794. 

Jenner’s  first  vaccination  was  performed  in  1796,  from  a  casual  vesicle 
on  the  hands  of  a  milker,  but  this  source  was  not  gone  on  with.  In  1798 
he  met  with  the  disease  again,  then  raised  his  first  stock  of  lymph.  After 
the  publication  of  Jenner’s  discovery,  accounts  were  obtained  of  cow  pox 
having  occurred  in  at  least  eighteen  counties  besides  Gloucestershire,  the 
county  in  which  his  own  observation  were  made.  In  January,  1799,  Wood- 
ville  met  with  the  cow-pox  in  the  London  dairies,  and  propagated  the  dis¬ 
ease  to  the  human  subject.  In  the  spring  of  the  same  year  cow-pox  was 
seen  in  North  Nibley,  in  Gloucestershire,  and  another  stock  obtained  from 
it  for  Jenner’s  use,  and  soon  after  he  also  obtained  a  new  supply  from  the 
Kentish  Town. 

In  1836,  Mr.  Leese,  one  of  the  vaccinators  of  the  National  Vaccination 
Establishment,  obtained  a  stock  from  the  cow,  and  propagated  it. 

In  1838,  the  disease  was  met  with  in  Gloucestershire  by  Mr.  Estlin;  in 
1838  or  1839,  iu  Dorsetshire,  by  Mr.  Fox,  of  Cune  Abbas ;  in  1839.  also  in 


16? 


History  of  Cow-Pox  Inoculation  in  England. 


Dorsetshire,  by  Mr.  Sweeting,  of  Abbotsbruy;  in  1838,  1840  and  1841,  in 
the  Yale  of  Aylesbury,  by  Mr.  Oeely ;  from  all  these  sources  lymph  was 
transferred  to  the  human  subject. 

No  doubt  the  disease  might  have  been  found  much  more  frequently  if  it 
had  been  only  thought  worth  while  to  look  for  it,  and  it  is  probable,  also, 
that  cases  had  been  found,  and  used  for  raising  lymph,  which  have  passed 
unrecorded. 

When  the  Epidemiological  Society  made  inquiries  in  1851,  several  in¬ 
stances  in  which  practitioners  had  met  with  cow  pox,  and  had  vaccinated 
with  the  lymph  obtained  from  it,  were  brought  to  light ;  as  by  Donald 
Dalrymple  of  Norwich,  by  Mr.  Beresford  of  Narborough,  in  Leicestershire  ; 
by  Mr.  Gorham  of  Aldeburgh,  bjT  Mr.  Alison  of  Great  Retford,  by  Mr. 
Coles  of  Leckhampton,  by  Mr.  Eudge  of  Leominster,  and  one  or  two 
others.  Mr.  Sweeting  met  with  the  disease  in  two  instances,  and  dissemi¬ 
nated  lymph  obtained  by  the  vaccination  of  persons  from  each  source. 

In  Ireland  cow-pox  was  early  reported  as  having  been  known,  and  anti- 
variolous  powers  attributed  to  it. 

It  is  also  worthy  of  note  that  Dr.  Gregory  experimented  with  a  renewed 
lymph  at  the  Small-Pox  Hospital*  in  1 836. 

The  source  of  the  new  lymph  is  not  mentioned,  but  the  difference  in  re¬ 
sults  from  the  lymph  in  use  at  the  hospital,  may  be  given  in  Dr.  Gregory’s 
own  words:  “the  lymph  in  use  at  this  hospital  has  been  preserved  in  un¬ 
interrupted  descent  for  a  very  long  period  of  time;  but  for  three  or  four 
years  past  I  have  noticed  that  its  intensity  was  diminished,  and  that  eight 
or  ten  incisions  produced  no  more  irritation  than  the  three  to  which  I  was 
accustomed  fifteen  years  ago.  In  March  last  (1836)  Mr.  Marson,  the  resi¬ 
dent  surgeon, employed  lymph  obtained  from  a  different  source.  This  lymph 
was  found  to  be  more  intense  and  active  than  the  old  lymph.  Three  or 
four  incisions  were  now  found  amply  sufficient;  and  so  satisfied  was  I  of 
the  superior  quality  of  the  new  lymph  that,  after  a  careful  trial  of  about 
two  months,  the  old  lymph  was  suffered  to  die  out,  and  for  the  last  six 
months  we  have  vaccinated  from  the  new  stock.  ,  The  facts  have  convinced 
me  that  vaccine  lymph  in  passing  through  the  bodies  of  many  persons  loses 
in  process  of  time  some  essential  portion  of  its  activity.  It  follows  from 
this  that  an  occasional  resort  to  primary  lymph  from  the  cow  becomes  a 
matter  of  great  importance,  perhaps  even  of  indispensable  necessity.” 


HISTORY  OF  THE  COW-POX  IN  IRELAND.  ’ 

According  to  Dr.  Samuel  B.  Labattf,  in  some  parts  of  Ireland,  particu¬ 
larly  in  the  County  of  Cork,  the  cow-pock,  under  the  name  of  the  shinach , 
has  for  ages  been  esteemed  a  perfect  preventive  of  the  small  pox,  so  much 
so  that  old  women  have  been  in  the  habit  of  bringing  children  to  the  neigh¬ 
boring  dairies  to  have  them  affected  with  it.  Dr.  Barry,  of  Cork,  gives 
many  instances  of  persons  having  had  the  cow-pox  more  than  fifty  years 
before  ;  and  informed  Dr.  Labatt,  that  one  woman,  aged  eighty  years,  as¬ 
serted  that  as  long  as  she  could  remember,  an  opinion  prevailed,  that  those 
who  had  the  cow-pock  cannot  take  the  small-pox,  and  that  people  pur¬ 
posely  exposed  themselves  to  the  former  under  that  persuasion. 

Dr;  Huston,  of  Colerain,  an  eminent  practitioner  of  long  standing,  and 
one  of  the  earliest  and  most  zealous  promoters  of  vaccination  in  Ireland, 
communicated  to  Dr.  Labatt  the  following  facts: 

*Medical  Gazette,  vol.  xxi.  p.  861. 

tAn  Address  to  tire  Medical  Practitioners  of  Ireland,  on  the  Subject  of  Vaccination.  Second  Edition.  By 
Samuel  B.  Labatt,  M.  D.,  etc.,  Dublin,  1840. 


168 


History  of  Cow-Pox  in  Ireland. 


“  Before  Dr.  -Tenner’s  discovery  of  cow-pock,  I  met  with  two  mothers  of 
families  who  had  not  had  small  pox,  and  when  inoculating  their  children,  I 
inoculated  the  mother  also.  All  the  children  passed  through  the  disease 
regularly  and  safely,  but  nothing  took  place  in  the  mother’s  but  a  trilling 
local  affection  ;  and  since  the  discovery  of  cow-pock  I  have  met  with  many 
females  who  never  had  small-pox,  and  I  inoculated  some  of  them  with 
small-pox  infection,  and  in  every  one  of  them  onty  local  affection  was 
produced ;  and  I  was,  in  several  instances,  able  to  trace  this  unsusceptibil¬ 
ity  to  their  having,  several  years  before,  contracted  infection  from  the  cow, 
in  their  hands  in  milking.  I  believe  that  almost  all  the  female  cases  here 
mentioned  were  owing  to  cow-pox  in  milking,  for  few  men  escaped  small¬ 
pox.’1 

A  gentleman  from  the  County  of  Wexford,  in  1804,  informed  Dr.  Labatt 
of  three  women,  who,  the  year  before,  in  consequence  of  milking  cows 
affected  with  sore  nipples,  were  attacked  with  considerable  inflammation  of 
their  hands,  attended  with  much  pain;  they  were  then  very  young,  and 
never  had  the  small  pox,  and  although  they  were  repeatedly  since  exposed  to 
the  contagion,  they  did  not  take  the  disease.  Before  the  publication  of 
Jenner’s  discovery,  cow-pox  had  long  been  known  in  Wexford  and  the  ad¬ 
joining  counties,  where  it  was  called  punthans  or  punclhane,  and  was 
esteemed  a  certain  preventive  of  small -pox ;  it  had  also  been  observed 
among  the  cows  in  the  neighborhood  of  Dublin. — An  Address  to  the  Medical 
Practitioners  of  Ireland,  on  the  Subject  of  Vaccination ;  Second  Edition ,  pp. 
27-28. 


HISTORY  OF  COW-POX  IX  THE  DUCHIES  OF  SCHLESWIG  AXD 

HOLSTEIX. 

The  knowledge  of  the  circumstances  of  the  origin  of  cow-pox  in  different 
countries  and  at  various  times,  is  of  great  importance  ;  for  to  this  source 
must  the  medical  profession,  in  all  time  to  come,  look  for  fresh  uncontamin¬ 
ated  supplies  of  vaccine  matter,  wherewith  to  protect  mankind  from  the 
inroads  of  small  pox. 

The  history  of  cow-pox  in  England  has  up  to  the  time  of  the  publication 
of  the  work  of  Dr.  Woodville,  been  fully  recorded  in  the  works  of  Jenner, 
Pearson  and  Woodville  ;  and  it  has  been  shown  that  the  disease  was  known 
in  Peru  and  Mexico  before  the  introduction  of  vaccination  in  those  coun¬ 
tries. 

The  most  important  addition  to  the  history  of  cow-pox  in  the  early  part 
of  the  eighteenth  century,  was  made  on  the  third  of  December,  1802,  by 
the  Medical  Faculty  of  Kiel,  in  their  report  to  the  Royal  German  Chan 
eery  of  Copenhagen,  relative  to  the  cow-pox  in  the  Duchies  of  Schleswig 
and  Holstein. 

The  report  of  the  Medical  Faculty  of  Kiel  was  signed  by  Drs.  Acker¬ 
man,  Weber,  Hensler,  Fischer  and  Pfaff,  and  was  based  upon  the  replies 
to  the  memorial  sent  by  them  to  all  the  districts,  and  other  physicians  of 
duchies  and  neighboring  provinces,  especially  the  Circle  of  Eaton,  and  cir¬ 
culated  still  more  generally  by  the  care  of  the  chancery. 

The  second  section  of  this  report  related  to  the  observations  which  had 
been  made  on  cow-pox  as  affecting  the  cow,  as  well  as  the  facts  known  in 
Holstein  prior  to  the  Jennerian  discovery;  the  effects  of  cowr-pock  on  the 
human  body,  and  especially  its  power  of  preventing  small  pox. 

In  arranging  the  facts  contained  in  the  report,  the  Faculty  of  Kiel  fol¬ 
lowed  the  order  in  which  the  questions  were  addressed  to  the  physicians  of 
both  duchies : 


history  of  Cow-Pox  in  Schleswig-Holstein. 


169 


1.  u  Rote  long  lias  the  cow-pox  been  lenown  in  either  duchy ,  according  to 
indisputable  evidence  V 

The  reports  unanimously  agreed  in  stating  that,  where  it  occurs,  it  has 
been  known  for  several  generations. 

Dr.  Heinze  referred  to  an  epidemic  cow-pock  among  the  herds  at  Olilen- 
rade  as  far  back  as  1746,  and  named  his  authorities,  who  were  then  living. 
A  countryman,  Daniels,  of  Halendort,  remarks,  that  before  the  time  of  his 
mother,  who  is  now  eighty  3rears  of  age,  the  cow-pox  was  known  ;  and,  in 
the  family  of  Inspector  Carstens,  at  Monch  Neversdorf,  the  knowledge  of 
it  goes  as  far  back  as  when  his  grandfather  was  a  boy. 

According  to  the  reports,  the  cow-pock  was  known  in  the  greater  part 
of  Holstein,  especially  on  the  noble  estates  in  the  Probstey  and  their 
neighborhood ;  in  the  contiguous  county  of  Oldenburgh  ;  in  the  county  of 
Eutin  ;  in  Oldesloe,  Legeberg ;  and  in  the  tract  of  country  from  there  to 
Kendsburg ;  in  short,  in  the  Eastern  parts  in  general,  while  it  is  totally 
unknown  in  the  Western,  as  in  Pennebury  ;  in  Gliickstadt;  and  especially 
in  the  parishes,  as  those  of  Norder  and  Siiderdithmarschen  ;  in  Wilster- 
marsch  ;  in  the  marshes  of  Schleswig,  Eiderstadt,  and  in  the  neighborhood 
of  Tondeln.  It  prevails  especially  among  the  numerous  herds  of  the  great 
dairies ;  commonly  spreads,  when  it  appears,  very  quickly  through  the 
whole  herd  ;  and  often  returns  to  the  same  herd,  like  the  epidemics  of 
small-pox  among  men,  after  longer  or  shorter  intervals  of  fifteen,  twelve, 
ten,  or  even  a  few  years.  On  the  contrary,  there  are  cases  where,  in  the 
course  of  thirty  or  forty  years,  it  has  only  appeared  once  in  the 
herds  of  the  same  dairy.  In  the  very  country  where  it  has  once  raged 
among  the  large  herds  of  the  dairies,  it  has  not  affected  the  single  cows  of 
the  peasantry. 

In  Wulfdorf,  the  cow-pox  was  epidemic  in  1762,  while  the  cows  were  still 
in  their  stables;  and  again  in  1764,  after  they  were  out  at  grass.  As  no 
vaccinations  were  taken,  it  affected  the  whole  of  them.  The  farmer  whose 
name  was  Stuhr,  did  not  regard  it,  as  he  knew  a  remedy  which  alleviated  it 
much,  and  rendered  it  very  short.  It  consisted  of  green  eupliorbium  in 
powder,  mixed  up,  to  the  state  of  a  thick  salve,  with  tresh  butter.  The 
size  of  a  pea  of  this  rubbed  into  every  pustule,  destroyed  the  poison  ;  and  a 
hard  crust  was  quickly  formed;  the  inflammation  of  the  teats  disappeared; 
the  crust  fell  off  in  a  few  days  ;  and,  in  a  few  days  more  the  teats  were  well. 
He  applied  the  same  remedy  to  the  hands  of  the  milkers  who  were  infected, 
and  often  prevented,  by  means  of  it,  the  painful  inflammation  of  the  arm. 

In  June,  1787,  the  cow-pox  appeared  in  a  herd  of  400  cows  at  Fulter- 
kamp,  and  became  general.  They  were,  in  general,  successfully  treated, 
by  the  application  of  a  compound  linament;  but  some,  to  which  it  was 
not  soon  enough  applied,  lost  their  teats.  Dr.  Heinze  quoted  thirteen  other 
cow-pox  epidemics,  which  prevailed  in  different  herds,  in  different  years, 
and  at  different  seasons  ;  and  by  which  individuals  were  infected,  who  re¬ 
sisted  the  small-pox  during  life. 

2  and  3.  u  What  different  hinds  of  cow-pox  are  hnown  in  your  district  f 
How  are  they  distinguished  from  each  other ,  by  color  or  other  character  ?v 

The  reports  furnished  less  conclusive  information  on  these  subjects.  In 
general,  they  agreed  that  there  are  several  kinds  of  pox  which  affect  the 
cow,  but  the  character  of  these  are,  in  part,  so  imperfectly  given,  that  an 
accurate  diagnosis  of  them  is  still  a  deficiency.  Several  reports  distin¬ 
guished  the  cow-pox. 

(a).  In  regard  to  itsintensity,  into  mild  and  malignant.  They,  however, 
were  said  to  resemble  each  other  in  their  essential  external  characters,  such 


170 


History  of  Cow-Pox  in  Schleswig-Holstein. 


as  color  and  form  ;  and  to  be  distinguishable  from  each  other  by  the  fol' 
lowing  circumstances: 

The  mild  are  more  distinct  (variol  discutce),  and  somewhat  larger,  be¬ 
ing  as  large,  or  larger,  than  a  pea;  all  the  symptoms  connected  with  them, 
as  the  swelling  of  the  teat  and  udder,  the  pain,  etc.,  are  milder ;  and  the 
subsequent  ulcers  are  not  so  deep,  and  heal  without  any  further  bad  con¬ 
sequences. 

The  malignant ,  on  the  contrary,  are  more  frequently  contiguous,  and,  as 
it  were,  confluent  ( variol  conH luentes),  and  smaller,  not  being  larger  than  a 
lentel;  and,  in  the  sequel,  form  a  confluent  ulcer,  covered  with  a  single 
crust,  accompanied  with  much  swelliug  and  pain,  and  even  sometimes  caus¬ 
ing  the  loss  of  the  whole  teat  or  udder. 

According  to  some  reports,  however,  the  malignity  of  the  cow-pox  ap¬ 
pears  to  be  connected  with  other  more  specific  differences  : 

(&).  From  the  reports  it  appeared  that  there  are  various  species,  differing 
in  their  color,  appearance,  form,  relation  to  the  small-pox,  etc. ;  but  in  most 
of  the  reports  the  characters  were  too  vague  to  admit  of  the  enumeration 
of  the  different  species  with  certainty. 

Dr.  Mssen,  by  transmitting  to  the  Medical  Faculty  of  Kiel,  colored 
drawings  of  the  different  kinds  of  cow-pox  seen  by  himself,  threw  the  great¬ 
est  light  on  this  subject.  By  comparing  these  drawings  with  the  other  re¬ 
ports,  the  Medical  Faculty  enumerates  the  following  kinds  of  cow-pox. 

1.  The  Blue  genuine  cow-pox ,  which  is  also  described  by  some  as  blue- 
grey,  pearl-colored,  and  even  white.  According  to  Dr.  Mssen,  they  are  the 
smallest  which  he  has  observed,  and  the  most  benign  ;  they  discharge  much 
matter,  and  the  ulcers  eat  somewhat  deep,  but  they  form  a  crust  much 
sooner  than  the  other  kinds. 

2.  Th q  yellow  cow-pox ,  which  was  stated  in  the  greatest  number  of  the  re¬ 
ports  to  be  smaller  than  the  former,  and  are  described  to  be  yellow  from 
their  first  appearance,  and  to  continue  so,  containing  a  yellow  matter,  are 
also  contagious,  but  according  to  one  account,  at  least,  do  not  afford  se¬ 
curity  asainst  the  small-pox.  As  observed  by  Dr.  Mssen,  the  yellow,  or 
brownish-yellow  cow-pox,  were  larger  than  the  blue,  and  almost  transpar¬ 
ent,  emtited  an  extremely  unpleasant  and  almost  putrid  smell ;  and  soon 
degenerated  into  itchy,  eating  sores,  from  which  matter  and  blood  fell  in 
drops.  In  cows  with  reddish  stripes,  they  had  more  of  a  brownish  color. 
They  were  infectious,  and  the  boils  and  ulcers  arising  from  them  had  the 
same  unpleasant  effect  on  those  who  milked  them.  Those  who  were  infect 
ed  by  them  were  often  confined  several  days  in  bed,  suffered  some  pain  in 
the  pustules,  and  were  in  danger  of  losing  some  of  their  fingers. 

To  this  species  belong  the  red  or  yellowish-red  variety,  to  which  Mr. 
Henckel,  surgeon  in  Lehnsahn,  gave  the  title  of  malignant,  and  which, 
when  together,  acquiring  the  appearance  of  yellow  wax,  and  stinking 
abominably. 

3.  The  Black  Cow-pox.  Dr.  Kessin  alone  described  them  minutely.  They 
were  larger  than'  the  blue  species  observed  by  him;  had  completely  the  ap¬ 
pearance  of  scrofula;  also,  degenerated  into  bad  ulcers,  like  the  yellow 
kind  ;  and,  in  the  manner  of  their  drying  up,  resembled  them  exactly.  On 
the  hands  of  the  dairy-maids  who  were'  infected  by  them,  they  were  equally 
large  and  black ;  and  when  they  changed  into  ulcers  are  particularly  deep, 

4.  Wind  Cow-pox ,  which  resemble  blisters,  and  contain  a  watery  fluid 
only;  they  are  said  to  be  less  infectious  than  the  yellow  cow-pox,  and  to 
afford  no  security  against  small-pox. 


171 


History  of  Cow-Pox  in  Schleswig-Holstein . 


5.  Red  Cow-pox.  Dr.  Heinze  remarked  them  in  about  twenty  cows  in 
the  country  meadow  iu  Pretz.  The  red  vesicles  stood  like  pearls,  and  con¬ 
tained  thin  matter. 

4.  What  influence  is  the  cow-pox  said  to  have  on  the  cow ,  and,  perhaps ,  also, 
on  other  animals  f 

All  the  reports  agree  that  the  cow-pox,  considered  as  a  general  disease, 
is  slight,  and  that  the  constitution  never  suffers  obviously,  since  during  its 
continuance  the  cows  eat,  chew  the  cud,  stale,  and  sleep  as  before ;  and, 
considered  as  a  local  disease,  the  degree  of  violence  varies  much  ;  but  even 
in  the  most  violent  degree,  the  general  health  does  not  suffer  obviously. 

It  was  always  treated  as  a  local  disease,  and  the  application  of  appropri¬ 
ate  remedies,  which  individual  farmers  and  cow  doctors  have  long  em¬ 
ployed,  and  which,  according  to  valuable  observations  communicated  with 
regard  to  them  by  Dr.  Heinze,  are  slight  caustics,  are  attended  with  speedy 
effect.  Even  the  secretion  of  milk  iu  many  cases  is  not  obviously  affected, 
and  in  the  worst  cases  not  entirely  suppressed. 

The  influence  of  cow-pox  iu  other  animals  is  not  mentioned  in  any  of 
these  reports,  and  one  of  these  distinctly  states,  that  other  animals,  as 
horses  and  sheep,  which  pasture  on  the  same  meadow  with  the  diseased 
herd  are  not  affected  by  it.  Also  all  these  reports  mention  only  the  cow- 
pox  of  milk  cows,  and  never  hint  at  its  being  communicated  to  calves,  bulls, 
or  oxen. 

5.  u  What  proof s  can  he  deduced  from  the  accounts  in  your  dictrict,  with  any 
certainty ,  that  cow-pox  is  a  preventive  of  small-pox  V 

The  greatest  number  of  reports,  from  the  districts  where  cow-pox  is 
known,  agreed  that  its  powers  of  preventing  small  pox  have  been  known 
as  long  as  the  disease  itself. 

About  fifty  cases  were  recorded  in  these  reports,  illustrating  the  security 
afforded  against  small-pox  by  cow-pox,  with  the  names,  age,  and  sex  of 
the  individuals  when  alive,  and  of  the  authorities,  when  dead,  specified. 
The  most  remarkable  was  that  of  a  woman,  still  alive  in  1802,  who  had  the 
cow-pox  when  a  year  and  a  half  old,  and  who  remained  secure  against 
small  pox  infection  for  sixty  years ;  another  fifty-six  years,  some  about 
forty,  several  thirty,  and  some  twenty,  almost  all  alive  in  1802. 

The  daughter  of  a  farmer  of  the  name  of  Priehm,  when  fourteen  years  of 
age,  was  affected  with  the  cow-pox  in  1746,  when  it  was  epidemic  in  the 
herd  at.Ohlensade.  She  married  a  M.  Martens;  lost  eight  children  in  the 
malignant  small-pox,  whom  she  attended  without  being  infected  ;  and  in 
1802,  being  above  seventy  years  of  age,  lived  with  her  son;  and  four  years 
before  nursed  her  grand  child  who  had  the  small-pox  from  inoculation. 

In  1742,  when  the  cow-pox  was  epidemic  in  Legalendorf,.  Mrs.  Volker, 
then  only  a  year  and  a  half  old,  was  infected  by  her  mother,  who  was  at 
that  time  obliged  to  assist  in  milking  the  cows.  On  returning  to  her 
house,  her  mother  took  her  out  of  the  cradle  to  wash  her,  probably  with¬ 
out  having  previously  washed  her  own  hands;  and  a  pustule,  which  had  a 
bluish  appearance,  and  had  a  large  areola,  appeared  on  one  of  the  labia 
pudendi.  In  1749  the  small  pox  came  into  the  country,  and  she  slept  in  the 
same  room  with  her  infected  brethren  ;  she  also  nursed  her  own  children 
when  ill  with  the  small-pox;  and  at  other  times  was  frequently  exposed  to 
infection.  In  1802,  she  was  sixty-three  years  of  age,  and  lived  with  her 
son-in-law,  Daniels,  in  Legalendorf,  and  was  still  proof  against  small  pox 
infection. 

Most  of  the  fif  y  cases  mentioned  in  the  reports  of  having  the  cow-pox, 
were  repeatedly  exposed  under  the  most  favorable  circumstances  to  the 


172 


History  of  Cow-Pox  in  Schleswig-Holstein. 


small-pox  infection,  and  five  of  them  allowed  themselves  to  be  inoculated 
for  the  small-pox  along  with  their  children,  without  any  effect,  although 
the  latter  took  the  disease. 

There  was  rarely  in  the  reports  any  specification  of  the  kind  of  cow-pox 
which  afforded  security  against  the  small -pox,  but  when  there  was,  it  is  re¬ 
ported  as  genuine  blue  cow-pox. 

Four  observations  of  an  opposite  character  were  recorded,  where  small¬ 
pox  occurred  after  cow-pox,  in  these  reports.  The  wife  of  Abraham,  steward 
at  Behrensbrock,  according  to  the  information  given  to  M.  Mehring,  Surgeon 
at  Emkendorf,  by  her  neighbor  Lerch,  who  himself  had  had  the  cow-pox 
several  times,  had  the  cow-pox  very  severely ;  and,  if  Lerch  remembered 
accurately,  even  several  times,  and  yet  she  died  of  small  pox  nine  years  be¬ 
fore  1802.  What  kind  of  cow-pox  she  is  said  to  have  had  is  not  mentioned. 
The  second  case  was  mentioned  by  Kofal,  the  dairy-woman  on  the  estate  of 
Caden,  to  the  steward.  Her  son  was  infected  pretty  severely  by  the  cow- 
pox  in  the  hands  and  arms,  in  consequence  of  milking  the  cows ;  and, 
almost  a  year  afterwards,  he  took  the  small-pox  along  with  the  rest  of  the 
children. 

This  was  a  case  of  infection  by  the  spurious  yellow  cow-pox,  as  was  fully 
proved  by  the  accurate  description  of  it,  and  by  other  circumstances,  as 
the  want  of  any  constitutional  affection,  except  the  pain,  and  the  absolute 
similarity  of  symptoms  in  those  affected,  whether  they  had  previously  had 
the  small  pox  or  not,  etc.  Mr.  Henckel,  of  Bensahn,  Surgeon,  relates  two 
cases,  but  which  on  the  one  hand  were  not  sufficiently  attended,  as  the  sub¬ 
jects  were  not  alive,  and  on  the  other  it  was  uncertain  whether  the  cow-pox 
which  failed  to  give  them  protection,  was  genuine  or  spurious. 

Dr.  Weber,  more  than  twenty-five  years  before  1802,  had  his  attention 
directed  to  the  cow-pox  by  landed  proprietors  and  dairymen,  and  made  his 
pupils  acquainted  with  the  subject.  Among  the  great  numbers  whom  he 
inoculated  with  small-pox,  he  always  met  several  from  the  country,  of 
whom  it  was  said,  that  the  inoculation  would  not  succeed,  because  they  had 
bad  the  cow-pox ;  and  this  was  most  commonly  the  case.  A  few  of  them 
only  took  the  small-pox  from  inoculation.  Even  at  that  time  he  was  in¬ 
formed  that  occasionally  country  people  inoculated  themselves  by  simply 
scratching  the  hand,  and  rubbing  in  fresh  cow-pox  matter,  to  prevent  them 
from  takiug  the  small-pox.  Two  girls,  effectually  inoculated  thus  with  the 
real  blue  cow-pox,  the  one  three  and  the  other  five  years,  afterwards  took 
the  small-pox  in  a  severe  and  confluent  form.  These  two  instances  Dr. 
Weber  knew  from  personal  observation  ;  and  he  had  heard  of  two  others 
from  a  farmer  well  acquainted  with  the  eruption,  one  of  which  was  his  own 
daughter. 

6  uHas  any  unpleasant  consequences  been  observed  from  the  action  of  the 
cow-pox  in  the  human  body  V1 

All  the  reports  agreed  that  the  cow-pox  was  followed  by  no  consequences 
prejudicial  to  health.  This  was  proved  by  instances  of  persons  who  had  the 
cow-pox  in  their  youth,  were  preserved  from  small -pox  all  their  lives,  and 
lived  to  the  age  of  sixty,  seventy  and  even  eighty.  The  cow-pox  received 
by  infection  in  most  of  these  reports,  is  described  as  very  mild,  so  far  as 
respects  the  general  affection,  and  also  as  a  local  disease!  A  single  case 
only  is  mentioned,  in  which  a  pretty  smart  fever  with  delirium,  arose 
from  infection ;  and  several  cases  were  quoted  where  the  local  affection 
was  considerable,  consisting  of  a  great  swelling  of  the  whole  arm,  with 
violent  inflamnation  and  pain,  but  without  being  followed  by  any  local  con¬ 
sequences. 


History  of  Cow-Pox  in  Schleswig-Holstein. 


173 


7.  u  What  effect  has  the  cow-pox  on  those  who  have  already  had  the  small-pox , 
especially  on  the  dairy-maids  f  ”  Most  of  the  reports  agree  that  those  girls 
who  have  had  the  small-pox  are  still  susceptible  to  the  cow-pox ;  but  at  the 
same  time  the  local  affection  is  much  slighter,  and  the  disease  was  then,  in 
the  strictest  sense  of  the  term,  local. 

8.  “  We  are  assurred  that ,  in  small  places  of  the  duchies ,  there  are  families 
of  country  people  in  which  either  the  real  inoculation  of  the  cow-pox ,  or  at  least 
intentional  infection ,  by  milking ,  has  for  several  generations  been  practiced , 
partly  as  a  secret  for  preserving  themselves  from  the  smallpox.  Are  there  any 
proofs  of  this  assertion  in  your  neighborhood  P’ 

Although  the  reports  contained  no  direct  answer  in  the  affirmative,  it 
may  be  concluded,  from  several  accounts,  that  particular  families  had  long 
availed  themselves  of  the  advantages  resulting  from  vaccination.  Several 
instances  are  related  in  which  they  intentionally  exposed  themselves  to  in¬ 
fection  from  pustules  in  the  cow,  or  even  practiced  inoculation  coarsely, 
and  recommended  it  to  others. 

It  is  further  remarkable,  in  this  point  of  view,  that  all  the  members  of 
the  family  of  the  Inspector  Carstens,  from  the  grand  father  downwards, 
viz.,  he  and  all  his  brethren,  the  father  of  Mr.  Carstens  and  his  mother, 
also  his  father-in-law  and  all  his  children,  including  Mrs.  Carstens,  were 
preserved  from  the  small-pox  by  having  the  cow-pox  in  their  youth. 

Dr.  Heinze  relates  a  remarkable  instance  which  fell  under  his  own 
observation,  of  a  schoolmaster,  Plett,  in  Laboc,  who,  in  1792,  inoc- 
culated  three  children  of  a  farmer  called  Martini,  at  Lammers- 
hagen,  by  introducing  fluid  matter,  taken  from  the  cow,  into  a  wound  made 
with  a  pen  knife  in  the  skin  between  the  fingers,  and  with  success,  as  they 
resisted  the  small  pox,  when  epidemic  there,  and  who  was  only  deterred 
from  continuing  the  practice,  by  the  great  swelling  in  the  arm  of  the 
youngest  child. 

9.  u  Is  there  any  positive  proofs  that  persons  having  the  co  w-pox  haV3  infected 


others  V 


One  instance  is  particularly  mentioned  by  the  Rev.  Mr.  Holst,  of  Riel, 
and  Dr.  Heinze,  with  the  names  of  all  the  parties,  some  of  whom  were  still 
alive,  of  a  person  who  was  infected  with  the  cow-pox  by  milking  a  cow,  com¬ 
municated  the  disease  to  her  sister’s  hand  by  rubbing  it  with  her  infected 
hand,  by  which  means  her  sister  was  secured  against  the  small  pox.  A 
second  case  was  mentioned  of  a  child  infected  by  its  maid  ;  and  a  third,  of 
a  child  by  its  mother,  who  had  previously  milked  a  cow  without  either  of 
them  Having  the  cow-pox  themselves. 

The  propagation  of  the  infection  amongst  the  cows,  was  chiefly  occa¬ 
sioned  by  the  hands  of  the  milkers,  even  when  these  were  only  soiled  with 
the  matter  from  the  cow,  and  not  themselves  affected  with  the  disease. 

With  reference  to  the  question  as  to  the  origin  of  the  cow-pox  from  the 
grease  (  Manke )  in  horses,  all  the  reports  with  the  exception  of  one  answered 
iu  the  negative.  Mr.  Fries,  surgeon  in  Pratz,  was  informed  by  a  veterinary 
surge  m  of  the  name  of  Brasch,  who  lived  upon  the  estate  of  Rixdorf,  that 
the  dairy-man  atTresdorf.  below  Rixdorf,  had  a  newly  foaled  mare,  so  very 
ill  with  the  grease ,  that  at  last  the  udder  was  affected  to  such  a  degree,  that 
the  foal  could  not  suck  her  any  longer.  He  therefore,  ordered  one  of  his 
maid-servants  to  milk  the  mare  daily,  and  every  day  after  milking  her,  to 
rub  her  hands  with  some  ointment.  This  girl  also  milked  the  cows;  and, 
in  a  short  time,  the  whole  of  them  were  affected  with  cow-pox,  of  which 
there  did  not  previously  exist  among  them  the  slightest  appearance.  If 
this  statement  is  accepted  as  correect,  it  is  an  evidence  that  the  disease 
was  not  confined  to  the  heel  or  the  horn  but  affected  the  entire  system,  and 
it  is  now  reasonable  to  regard  this  as  an  instance  of  horse-pox. 


174 


Cow-Pox  in  Germany. 


This  view  is  sustained  by  the  observations  of  Mr.  Kolen,  a  veterinary 
surgeon,  to  the  effect  that  persons  who  dressed  the  horses’  heels  afflicted 
with  the  grease  (Manke)  and  then  milked  the  cows,  failed  to  communicate 
the  cow-pox ;  and  of  the  Privy  Counsellor,  Von  Thienen,  that  on  his  estates, 
which  were  very  wet,  the  grease  was  very  frequent,  while  the  cow-pox,  in 
a  period  of  forty  years,  has  appeared  in  some  of  them  only  once,  and  others 
not  at  all ;  these  marshes,  and  some  other  situations,  where  the  grease  is 
very  common,  being  free  from  the  cow-pox;  the  frequency  of  cow-pox  in 
Holstein,  where  the  milk-maids  have  no  connection  whatever  with  the  horses. 


COW-POX  IX  GERMANY. 

In  Germany,  after  the  promulgation  of  Jenner’s  discovery,  inquiries 
showed  that  cow-pox  had  been  recognized  in  various  places,  especially  in 
Mecklenburg,  Holstein,  Brandenburg,  Silesia,  in  the  country  about  Greis- 
sen  and  Erlargen,  and  also  in  Switzerland.  A  statement  was  found  in  a 
Gottingen  newspaper,  of  the  date  of  1769,  that  this  disease  had  been  often 
seen  about  this  place,  and  milkers  affected  by  it  were  thereby  protected 
against  the  small-pox. 

An  instance  of  cow-pox  occurred  in  Wirtemberg  in  1802.  In  1812,  the 
disease  was  seen  in  Berlin  and  its  environs,  by  Bremer ;  near  Luneburg, 
by  Fischer,  and  in  Greifswalde  by  Mende;  in  1816,  at  Leggerde  in  Bruns¬ 
wick,  by  Giesker.  In  the  eleven  years  preceding  1824,  Luders  saw  several 
epizootics  ot  the  disease  in  Holstein,  and  in  1824,  1825,  1829,  1830  and 
1832,  Ritter  made  some  successful  vaccinations  from  cows  which  he  found 
suffering  from  it  in  various  parts  of  Schleswig-Holstein. 

Ritter  says  that  in  some  parts  of  Schleswig-Holstein  the  disease  is  very 
common  ;  he  had  himself  seen  it  on  many  previous  occasions,  but  not  in 
the  stage  admitting  lymph  to  be  taken,  nor  till  the  pustules  on  the  milkers’ 
hands  had  become  sores.  Probable  examples  of  the  disease  were  then  met 
with  in  1829  by  Riss  at  New  Breisach,  and  by  Albers,  near  Stralsound,  in 
1834.  The  history  of  the  discovery  of  cow-pox  in  Wirtemberg  is  interesting 
as  showing  liow  much  these  discoveries  depend  on  the  zeal  with  which  the 
disease  is  looked  for.  In  as  much  as  the  tendency  of  all  herd-keepers  and 
their  servants  is  to  keep  secret  the  existence  of  any  disease  among  their 
cattle,  the  Government  offered  premiums  for  the  discovery  of  natural 
cow-pox  in  the  cow  ;  and  in  1825  it  was  determined  that  a  prize  should  be 
given  for  each  case  of  cow-pox  reported,  which  should  be  found  in  such  a 
state  that  the  character  of  the  disease  could  be  well  ascertained,  and  the 
case  used  for  vaccinating  from.  Cases  were  met  with  every  year,  and  in 
eleven  years  (1827-37)  the  genuine  cow-pox  was  found  (in  a  state  that  suc¬ 
cessful  vaccination  could  be  performed  from  it)  in  sixty-nine  different 
places,  the  cows  affected  by  it  amounting  to  eighty-four;  besides  which 
there  were  reports  from  152  places,  regarding  208  cows,  in  which  the  dis¬ 
ease  probably  was  cow-pox,  though  vaccinations  were  either  not  performed 
at  all  from  them,  or  were  unsuccessful. 

In  Holland,  according  to  Xumann,  cow-pox  was  seen  in  1805,  in  1811,  and 
in  1824. 

In  Russia,  in  1838,  an  epizootic  of  cow-pox  is  said  to  have  occurred  among 
the  cows  in  a  village  in  the  neighborhood  of  St.  Petersburg. 

In  Italy,  cow-pox  was  discovered  in  1800,  on  the  plains  of  Lombardy  by 
Saceo,  and  again  in  1808  and  1809,  by  the  same  successful  vaccinator ;  in 
1830  it  was  seen  in  Peidmont.  In  1812  it  was  discovered  at  Naples.  In 
1832  and  1834,  it  was  found  at  Rome  on  cows  of  Swiss  breed,  by  Dr.  Macer- 
oni,  and  in  1834,  a  lymph  stock  was  established. 


175 


Clow-Pox  in  France. 


COW-POX  IN  FRAXCE. 

In  France,  cow-pox  is  said  to  have  been  found  in  1810  in  the  department 
of  La  Meurthe  ;  and  in  1822,  at  Clairveaux.  In  1836,  it  was  discovered  at 
Passy,  Amiens  and  Eambouillet ;  in  1839  it  was  discovered  at  Rouen;  in 
1841,  at  Saint  Illide,  at  Saint  Seine,  at  Pertlliac;  in  1S42,  at  Pagnac  ;  in 
1843,  at  Veux  Junieaux;  in  1844  in  a  cow  belonging  to  M.  Magendie ;  in 
1846  in  three  departments  ;  in  1852  at  Eheims,  and  also  in  the  department 
ol  Eure-Et-Loire  ;  in  1854,  in  the  arondisement  of  Sancerreand  at  Bezieres  ; 
in  1863,  at  Guzonville ;  in  1864,  on  farms  in  three  villages  near  Xogent,  at 
Petit  Quevilly,  near  Rouen.  In  1866,  cow-pox  was  discovered  at  Beau- 
gency. 


OBSERYATIOXS  OF  M.  J.  B.  BOSQUET*  OX  THE  COW-POX 
(PETITE-VEROLE  DES  VACHES),  DISCOVERED  AT  PASSY 
XEAR  PARIS,  OX  THE  TWEXTY-SECOXD  OF  MARCH,  1836. 

On  the  twenty-first  of  March,  1836,  a  woman  residing  at  Passy,  a 
milker,  applied  to  a  medical  man  in  the  neighborhood  on  account  of  an 
eruption  upon  her  hand.  He  recognized  the  affection  as  the  cow-pox,  and 
the  same  day  sent  the  woman  to  M.  Bosquet. 

to  Bosquet  states  that  there  were  vaccine  pustules  on  the  right  hand  and 
one  upon  the  upper  lip,  and  he  was  struck  by  the  unusual  bluish  tint  they 
exhibited,  such  as  Jenner  had  mentioned  as  a  characteristic  of  the  cow- 
pox.  From  a  pustule  on  the  hand  he  vaccinated  nine  children.  The  lymph 
was  taken  late  in  the  course  of  the  disease;  it  was  thick,  white  and  puru- 
u  lent.  Bosquet,  however,  vaccinated  the  children  with  it  by  three  punctures 
on  the  left  arm,  and  used  the  ordinary  humanized  lymph  in  three  places 
upon  the  right  arm.  In  one  of  these  nine  children  no  effect  followed  in 
either  arm;  in  the  others  the  old  lymph  took,  and  from  twenty-four  punct¬ 
ures  there  were  obtained  twenty-two  pocks.  But  in  only  three  of  these 
eight  children  did  the  new  lymph  take  upon  the  left  arm,  and  in  each  of 
them  it  took  only  in  one  place.  Only  one  of  these  three  children  returned 
for  examination  on  the  eighth  day — a  weakly,  puny  infant,  three  months  of 
age;  three  punctures  on  the  right  arm  with  the  old  lymph  and  one  upon 
the  left  arm  with  the  new,  had  given  rise  to  pocks  as  miserable  and  lan¬ 
guishing  as  the  child  itself.  M.  Bosquet  took  lymph  from  the  pock  on  the 
left  arm  resulting  from  the  vaccination  with  the  cow-pox  matter,  and  vac¬ 
cinated  four  other  children  on  the  left  arm,  again  making  a  comparative 
vaccination  with  the  old  lympt  upon  the  right  arm. 

All  the  punctures  took — the  three  with  new  virus  on  the  left  arms  and 
the  three  with  old  virus  on  the  right — on  all  the  four  children. 

The  vesicles  ran  a  completely  parallel  course  up  to  the  seventh  day,  when 
a  difference  became  perceptible  in  favor  of  the  new  virus.  The  vesicles 
were  better  formed,  flattened  and  more  depressed  in  the  centre  on  the  eighth 
day  than  those  from  the  old  virus,  more  brilliant  in  appearance  and  firmer, 
and  the  lymph  they  contained  was  as  clear  as  crystal.  On  the  twelfth  day 
the  difference  was  still  more  marked;  the  new  vesicles  were  flat  and  nearly 
four  lines  broad,  firm  at  the  border,  prominent  and  full  of  force  and  vital¬ 
ity  ;  the  old  ones,  on  the  other  hand,  were  already  beginning  to  dry  up. 


*Sur  le  Cow-pox  (Petite- Verole  des  Vackes)  Decouvert  a  Passy  (Pres  Paris),  le  22  Mars,  1736.  Notic  epar 
/!<  J.  B  Bc^quet,  Seordtaire  du  Conseil  et  Mernbre  de  l’Acadfimie  Royale  M6decin6,  Charg6  des  Vaccinations 
Gratuites,  Chevalier  de  laL6gion-d’Honncur,  etc.  Are  une  Planclie  Cilri6e.  A  Paris,  1836. 


176 


Cow-Pox  in  Prance. 


M.  Bosquet  presented  in  his  valuable  memoir  on  the  cow-pox  discovered 
at  Passy,  in  1836,  the  following  comparative  view  of  the  effects  of  the  old 
humanized  and  the  new  lymph : 


ANCIEN  VACCIN. 

1°.  Les  deux  premiers  jours  aprds  l’opera- 
tion,  les  piqftres  ue  prdsentent  rien  d’appa- 
rent. 

2. °  Du  troisidme  au  quatridme,  on  aper- 
foit  un  petit  point  rose,  plus  sensible  au 
doigt  qu’il  l’ceil. 

3. °  Des  le  cinquidme  1a,  pustule  vaccin- 
ale  commence  a  se  dessmer  avec  tous  ses 
caractdres;  ddja  plate  a  son  soumet,  ldgdre- 
ment  ddprimde  au  centre  ;  les  jours  suivaus 
ces  caracteres  ne  font  que  se  rnarquer  da- 
vantage. 

Au  septidme  jour  la  pustule  tout  entidre 
reflete  cet  dclat  argentd  qui  la  caractdrise, 
et  commence  a  s’eutourer  d’une  petite  ard- 
ole  rouge. 

La  consistance  en  est  si  molle,  que  pour 
peu  qu’on  y  touche  avec  la  lancette,  elle  se 
vide,  et  le  virus  qui  en  soit  est  ddjit  un  peu 
louche. 

4°.  Au  huitidme  jour  l’ardole  gramlit ; 
au  nenvieme  elle  s’efface ;  la  pustule  plus 
large  et  plus  haute,  se  ramollit  encore.  Le 
centre  se  courinne  d’un  point  brun,  signe 
certain  d’un  commencement  de  dessiccation. 

Le  virus  se  trouble  de  plus  en  plus. 

5°.  Du  dixieme  au  douzieme  jour  la  des¬ 
siccation  fait  des  progrds  rapides  Le  bou¬ 
ton  tout  entier  se  couvred’uue  croftte  jaun- 
ittre  encore  molle,  laquelle  brun  it  de  plus 
en  jdus,  et  se  rapetisse  en  prenant  plus  de 
solidity. 


6°.  A  partir  du  trezieme  jour,  la  croftte 
rdduite  au  volume  d’une  grosse  lentille,  se 
sdche  toujours  davantage,  et  en  sdchant 
elle  dimiuue  eucore.  Elle  tombe  commune- 
inent  du  quinzieme  aux  dix-liuitidme  jour. 

Les  cicatrices,  en  gdndral  trds  superfici- 
elles,  se  font  plutot  reconnaitre  a  leur  teinte 
rougeatre  qu’ala  depi’ession  qu’elles  laissent 
a  la  peau.  Mais  au  bout  de  quelque  mois, 
la  peau  revient  it  son  ton  naturel,  et  l’ceil 
apeine  a  retrouvde  les  trace  de  la  vaccine. 


NOUTEAU  VACCIN. 

1°.  Des  le  l’endemain  de  l’operation,  on 
distingue  ordinairement  un  point  rouge  qui 
indique  un  commencement  de  travail. 

2°.  Ce  point  d’un  rouge  plus  vif,  est  aus- 
si  sensible  it  l’ceil  qu’au  toucher. 

3°.  Mdmes  caractdres,  exceptd  qu’ils  sont 
mieux  dessinds;  la  depression  est  plus  mar¬ 
quee,  l’dclat  plus  brillant,  la  consistance 
beaucoup  plus  ferine. 

Le  virus  est  parfaitement  lempide. 

II  n’y  a  pas  encore  vestige  d’ardole. 


4°.  Le  bouton  n’est  jamais  plus  beau, 
plus  ferine,  plus  brillant. 

L’ardole  commence  a  se  prononcde. 

Le  virus  conserve  sa  transparance  et  sa 
puretd. 

5°.  La  pustule  se  ddvelloppe  en  tous 
sens,  sans  changer  de  caractdre. 

L’ardole  est  large  et  vive,  le  tissu  sons- 
pacent  profondemeut  engorgd.  Les  glandes 
de  l’aisselle  souvent,  douloureuses,  tumifids, 
principalement  chez  les  adultes. 

Ndaumoins  il  n’y  a  pas  toujours  de  fidvre, 
s’il  y  en  a,  c’est  principalement  it  ce  mo¬ 
ment  qu’elle  est  sensible. 

Le  virus  commence  it  se  troubler ;  mais  il 
n’en  est  pas  moins  bon  it  transmettre. 

6°.  Les  pustules  d’un  diamdtre  de  trois  it 
quatres  lignes,  clesdchdes  au  centre,  prd- 
sentent  un  bounelet  circulaire  sailiant  dle- 
vd,  et  dont  la  transparence  indique  assez 
l’dtat  du  vaccin  qu’il  coutient. 

Cet  dtat  dure  jusqu’au  quinzidme  jour,  et 
quelquefois  davantage. 

L’ardole  est  encore  tres  vive  et  trds  eten- 
due,  coinnie  on  peut  voir  par  la  graveur. 


7°.  Du  quinzieme  au  dix-huitidme  jour 
la  dessiccation  s’dtend  it  toute  la  surface  de 
la  pustule.  La  croftte  est  plate,  large, 
brune  et  comme  terrdtide.  Pour  la  couleur 
je  ne  saurais  mieux  la  comparer  qu’it  une 
amande  grille. 

En  mdme  temps  l’ardole  pdlit  et  se  retire 
iusensiblement  jusqu’a  ce  que  entin  elle 
s’elface  compldteuient. 

La  chute  des  crotttes  se  fait  commence¬ 
ment  du  vingt-cinquidme  au  trentidrne  jour. 

Aux  crotttes  succedent  des  cicatrices 
larges,  profondes  et  traversdes  par  une 
foule  de  petites  brides  qui  leur  donnent 


Cow-Vox  in  France. 


177 


ANCIEN  VACG'IN.  NOUVEAU  VACCIN. 

l’aspect  reticulA  Eu  y  posaut  le  doigt,  on 
sent  une  cavit6  coniine  s’il  y  avait  en  perte 
de  substance. 

11  n’est  pas  rare  qne  les  croiltes  laisseut 
aprbs  elles  un  plaie  snppnrante,  nn  uleure 
dont  il  faut  atteudre  la  cicatrisation. 

J’ai  vu  des  pustules  crensu  si  profondd. 
ment  la  peau  qu’elles  y  faissaient  de  verd- 
tables  trous.  pp.  18-19: 

We  may  thus  briefly  sum  up  the  results  obtained  by  M.  Bosquet  from 
the  use  of  the  old  and  new  lymphs  in  the  numerous  comparative  vaccina¬ 
tions  which  he  performed. 

The  new  vaccine  proceeds  in  its  course  at  once  more  quickly  and  more 
slowly  than  the  old — more  quickly  in  that  it  sooner  gives  signs  of  life, 
more  slowly  in  that  its  career  is  more  prolonged.  The  resemblance  between 
the  two  sources  of  virus  is  at  no  time  greater  thau  on  the  seventh  or  eighth 
day.  From  that  period  the  vesicles  are  quite  distinguishable  the  one  from 
the  other,  and  the  more  they  advance  the  more  pronounced  becomes  the 
separation.  As  to  the  size,  those  of  the  new  vaccine  often  acquire  a  size 
almost  double  that  of  the  others  ;  they  are  also  flattened,  more  brilliant, 
more  umbilicated,  better  defined,  and  firmer.  When  looked  at  closely,  they 
present  to  the  eye  a  grained  surface,  something  like  that  of  the  rind  of  an 
orange,'  they  appear  to  be  more  closely  and  firmly  attached  to  the  skin,  and 
as  they  become  more  developed  they  raise  and  drag  upon  it  5  while  the  old 
vesicles  are  slighter,  more  superficial  to  the  eye,  and  more  raised,  and  look 
as  if  separate  from  the  skin,  more  after  the  manner  of  a  “  vesicle.”  Cor¬ 
responding  to  this  is  the  areola;  in  the  one  it  is  active,  extended  and 
phlegmonous ;  in  the  other,  slight,  fugitive  and  erysipelatious. 

Bosquet  describes  the  cicatrix  in  the  old  and  new  virus : 

Old. — The  scars  are  in  general  very  superficial,  and  make  themselves 
evident  when  the  crust  has  fallen,  rather,  by  their  reddish  tint  than  by  any 
depression  left  in  the  skin.  At  the  end  of  some  months,  however,  the  eye 
can,  with  difficulty,  if  at  all,  discern  any  cicatrical  trace  whatever. 

New. — The  crusts  are  succeeded  by  large  cicatrices,  traversed  by  a  mul¬ 
titude  of  little  bands  or  bridles,  which  give  them  a  reticulated  appearance. 

*  Laying  the  finger  in  one  of  these  a  cavity  is  easily  perceived,  as  if  there  had 
been  a  decided  loss  of  substance.  It  is  not  uncommon  for  the  crust  to 
leave  after  them  suppurating  wounds  or  ulcers,  the  cicatrization  of  which 
may  be  considerably  delayed. 

M.  Brucliir,  of  Versailles,  also  made  comparative  re-vaccination  upon 
twelve  persons,  using  the  new  lymph  upon  one  arm  and  the  old  upon  the 
other;  he  found  that  the  new  produced  well  developed  and  perfect  pustules, 
equal  in  numbers  to  the  punctures,  while  the  old,  if  it  took  at  all,  gave 
only  modified  or  false  pustules.  Several  medical  men  experimented  sub¬ 
sequently  with  the  new  lymph,  and  their  observations  confirmed  those  of 
M.  Bosquet. 

Similar  results  were  obtained  by  Mr.  Estlin,  by  the  use  of  cow-pox  mat¬ 
ter,  which  he  obtained  on  August  18,  1888,  on  a  farm  in  Gloucestershire, 
where  several  of  the  cows  were  affected  and  where  the  farm  servants  had 
received  the  contagion.  (Medical  Gazette,  vol.  22,  p.  977,  “Accounts  of  a 
Supply  of  fresh  Vaccine  Virus  from  the  Cow.”  Medical  Gazette,  vol.  24, 
]>,  2075. 

Steinbrenner’s  observations  with  Mrs.  Pass’s  lymph  in  1840,  and  with 
new  lymph  obtained  from  other  sources  1841  and  1845,  confirmed  the  accu¬ 
racy  of  the  results  announced  by  Bosquet  in  1836. 


173 


Discovery  of  Cow-Pox  in  America. 


DISCOVERY  OF  COW-POX  IX  AMERICA. 


Don  F.  Xavier  Balmes,  Director  of  tlie  Spanish  Vaccine  Expedition,  dis¬ 
covered  cow-pock  in  the  cows  of  the  valley  of  Allixico,  near  the  city  of 
Puebla  de  los  Angelos,  in  the  neighborhood  ot  Volladolid,  in  Mechvachan, 
and  in  the  districts  of  Calaboza,  in  the  province  of  Caraccas,  and  in  the 
Peruvian  Andes. 

Dr.  Waterhouse  informed  Dr.  Jenner  of  the  existence  of  cow-pock  in  sev¬ 
eral  parts  of  America,  where  its  anti- variolous  power  was  not  unknown. 

“As  one  of  our  periodical  inoculations,’7  says  Dr.  Waterhouse,  “which 
occur  in  Xew  England  once  in  eight  or  nine  years,  some  people  drive  their 
cows  to  an  hospital,  near  to  a  populous  village,  in  order  that  their  families 
might  have  the  daily  benefit  of  their  milk.  These  cows  were  milked  by 
X>ersons  in  all  stages  of  small-pox,  the  consequence  of  which  was,  the  cows 
had  an  eruptive  disorder  on  their  teats  and  udders*  so  like  small-pox  that 
every  one  in  the  hospital,  as  well  as  the  physician  who  told  me,  declared 
the  cows  had  the  small-pox.” 

Thus  according  to  Dr.  Waterhouse  the  human  small-pox  was  conveyed  to  the 
cow ,  in  the  same  manner  as  the  cow-pock  teas  communicated  from  the  cows  to 
the  milkers  in  dairy  countries ,  and  the  statement  was  strongly  confirmative  of 
the  doctrine  of  the  identity  of  small-pox  and  cow-pox. 

The  important  services  rendered  the  citizens  of  the  United  States  of 
America  by  Dr.  Waterhouse  and  President  Jeffersou,  in  the  introduction  of 
vaccination  into  the  United  States  will  receive  due  consideration;  we  re¬ 
gard  it  of  importance  to  place  in  the  following  facts  in  chronological  rela¬ 
tion  with  the  discovery  of  cow-pox  on  the  American  continent. 

Professor  Waterhouse  wrote  thus  to  Dr.  Samuel  Mitchell,  of  Xew  York, 
editor  of  “  The  Medical  Repository  and  Review  of  American  Publications,” 
in  a  letter  dated  Cambridge,  Massachusetts,  September  26,  1801. 

“President  Jefferson  informs  me  that  the  kine-pox  has  pervaded  or  is 
pervading  his  family  at  Monticello,  more  than  twenty  having  gone  through 
the  genuine  disease — at  least  I  presume  so  from  the  virus  sent  him,  and  the 
description  he  has  given  me  of  its  effects.  It  is  progressing  in  this  quar¬ 
ter  with  undeviating  success,  very  few  spurious  cases  having  occurred  this 
season.  # 

“Yesterday  I  received  a  letter  from  Doctor  Jenner,  one  paragraph  of 
which  I  must  transcribe,  because  it  contains  the  golden  rule  of  vacccination. 

“  I  don’t  care  what  British  laws  the  Americans  discard,  so  that  they 
stick  to  this — Never  take  the,  virus  from  a  vaccine  pustule ,  for  the  purpose  of 
inoculation  after  the  efflorescence  is  formed  around  it.  I  wish  this  efflores¬ 
cence  to  be  considered  as  the  sacred  boundary  over  which  the  lancet  should 
never  pass.” — Medical  Repository ,  vol.  5,  p.  235. 

In  the  history  of  cow-pox  inoculation  in  the  United  States,  it  was  felt 
at  an  early  date,  that  a  necessity  existed  of  establishing  a  point  of  time  for 
taking  the  vaccine  virus  for  the  purpose  of  inoculation ,  as  a  popular  criterion. 

It  was  difficult  if  not  impossible  correctly  to  apply  Jenner’s  golden  rule 
in  the  practice  of  cow-pox  inoculation  amongst  the  African  Xegro  slaves 
of  the  United  States,  owing  to  the  color  and  structure  of  the  skin  of  their 
bodies. 

In  a  letter  from - to  Dr.  Waterhouse,  dated  Washington,  De¬ 

cember  25,  1801,  the  following  inquiry  was  made: 

“Knowing  how  little  capable  the  people  in  general  are  of  judging  be¬ 
tween  genuiue  and  spurious  matter  from  their  appearance  or  that  of  the 
pustule,  I  endeavored,  in  the  course  of  my  inoculations  at  M — : - ,  to  fiud 


Discovery  of  Cow-Pox  in  America. 


179 


some  other  criterion  for  their  guide.  With  this  view,  I  was  very  attentive 
to  discover  whether  there  was  a  point  of  time ,  counting  from  vaccination 
when  the  matter  is  genuine  in  all  cases.  I  thought  that  eight  times  twenty- 
four  hours  furnished  such  a  point.  I  governed  myself  by  it,  and  it  has 
been  followed  here  successfully  by  Dr.  Gantt;  but  your  experience,  so 
much  greater,  can  inform  us  whether  this  rule  is  a  sure  one,  or  whether 
any  other  point  of  time  would  be  still  pi  ore  certain.  To  the  eye  of  experi¬ 
ence  this  is  not  necessary,  but  for  popular  use  it  would  be  all-important; 
for  otherwise  the  disease  degenerates  as  soon  as  it  gets  into  their  hands, 
and  may  produce  a  fatal  security.  1  think  some  popular  criterion  necessary 
to  crown  this  valuable  discovery.” 

The  following  is  the  answer  of  Dr.  Waterhouse : 

“  I  was  forcibly  impressed  with  the  necessity  of  fixing  on  some  point  of 
time,  by  way  of  popular  guide,  when  to  take  the  vaccine  fluid  for  the  pur¬ 
pose  of  inoculation,  in  order  to  prevent  the  evils  you  suggest. 

“  I  know  that  the  perfection  of  the  virus  differs  somewhat  in  different 
subjects ;  but  in  the  formation  of  a  general  rule  it  is  necessary  to  impose  a 
limitation.  Dr.  Jenner  says,  L I  prefer  the  fifth  day,  or  the  sixth,  or  the 
seventh,  eighth,  or  (if  the  efflorescence  is  not  far  advanced  beyond  the  mar¬ 
gin  of  the  pustule)  the  ninth  day.’  But  I  conceive  this  is  impossible  to  be 
discovered  with  requisite  precision  on  the  skin  of  the  African.  The  crite¬ 
rion  of  lympid  matter  is  fallacious;  for,  in  the  rising  of  a  vesicle  from 
almost  any  cause,  the  scarf-skin  separates  from  the  true,  and  a  portion  of 
the  superfluous  water  of  the  blood,  and  sometimes  of  the  coagulable  lymph 
is  found  under  it.  I  have  known  this  limpid  fluid  exude  in  considerable 
quantity  from  the  vaccine  pustule  that  has  been  too  much  irritated  by 
pricking,  and  exhausted  of  its  virus.  It  gives  a  shining,  glazy  appearance 
to  the  thread.  I  know  of  no  writer  or  practitioner  who  has  made  this  dis¬ 
tinction. 

“Were  I  then  to  fix  on  a  point  of  time,  of  all  others,  as  a  general  and 
popular  rule,  I  should  say  eight -times  twenty-four  hours ,  this  being  the  re¬ 
sult  of  my  own  experience.  “BENJAMIN  WATEliHOUSE. 

“Cambridge,  Jan.  28,  1802.” — Medical  Repository,  vol.  5.,  p.  347. 

Dr.  Samuel  T.  Mitchell  and  Dr.  Edward  Miller,  of  New  York,  editors  of 
The  Medical  Repository  and  Review  of  American  Publications ,  at  an  early 
day  in  the  history  of  vaccination,  suggested  to  the  physicians  of  the  United 
States,  to  inquire  for  the  vaccine  disease  among  the  cows  of  this  country. 
— See  Medical  Repository ,  vol.  4,  p.  322. 

Dr.  William  Buel  of  Sheffield,  in  the  State  of  Massachusetts,  in  a  letter 
to  Dr.  Edward  Miller,  dated  twentieth  May,  1801,  describes  the  case  of  a  lad 
in  his  neighborhood  affected  with  an  eruption  on  the  face  and  hands,  greatly 
resembling  vaccine  pustules,  to  whom  he  was  called  on  the  tenth  of  the 
preceding  month.  With  matter  taken  from  these  pustules,  he  inoculated 
several  persons,  and  observed  the  disease  to  pursue  a  similar  course  and 
to  exhibit  similar  phenomena  to  a  case  of  actual  vaccine  pox  under  his  care. 
And  after  the  termination  of  this  new  disease,  he  tested  it,  as  usual,  by 
variolous  inoculation,  with  the  same  happy  results  as  in  other  cases  of 
vaccine  pox.  Upon  inquiry  he  found  that  he  had  sometimes  milked  cows, 
that  these  cows  had  been  observed  to  have  sore  teats,  and  that  the  hands 
and  face  of  the  lad  had  been  prepared  for  the  reception  of  the  disease  by 
having  been  previously  scratched  in  play  with  his  companions. 

Dr.  Elisha  North,  of  Goshen,  in  the  State  of  Connecticut,  who  had  bestowed 
much  attention  on  the  vaccine 'disease,  found  it  among  the  cows  of  that 
neighborhood,  and  inoculated  it  with  success. 


180 


Introduction  of  Vaccination  into  the  United  States. 


In  a  letter  of  the  twenty-fifth  of  May,  1801,  to  Dr.  Edward  Miller,  he  an¬ 
nounced  the  discovery  of  cow-pox  and  stated  that  the  inoculation  of  the 
disease  had  been  tried  in  a  number  of  instances  with  complete  success. 

Dr.  Joseph  Trowbridge  of  Danbury,  in  the  State  of  Connecticut,  in  a  let¬ 
ter  to  Dr.  Samuel  L.  Mitchell,  dated  the  sixth  of  July,  1801,  communicated 
a  similar  discovery  which  he  had  made  among  the  cows  of  that  place.  At 
that  time  he  had  inoculated  three  persons  of  his  own  family,  and  the  disease 
produced  by  the  inoculation  exhibited  all  the  appearences  of  the  genuine 
vaccine  pox.  Medical  Repository ,  vol.  5,  New  York,  1802,  p.  92. 


INTRODUCTION  OF  VACCINATION  INTO  THE  UNITED  STATES 

OF  AMERICA. 

Since  the  spreading  of  the  small  pox  on  the  earth,  by  the  increased  in¬ 
tercourse  of  mankind,  its  violence  had  been  seriously  felt  by  most  civilized 
nations,  frequently  by  the  uncivilized  people  who  traded  with  them. 
Dreadful  were  its  ravages  in  Europe  before  the  Asiatic  method  of  lessen¬ 
ing  its  fury  by  inoculation  was  introduced;  and  even  after  that  time,  and 
the  adoption  of  this  artificial  and  safe  method  of  infecting  the  constitution 
with  the  venom,  the  benefits  by  inoculation  were  only  partially  experienced 
for  it  tended  to  keep  alive  the  disease;  the  introduction  of  small  pox,  even 
in  the  inoculated  form,  had  been  prohibited  in  some  States  by  laws;  and 
in  others  where  no  such  prohibition  existed,  the  expense  and  trouble  of 
undergoing  the  disease,  debarred  many  from  submitting  to  its  operation. 

It  seemed  politic  and  proper  to  the  governments  of  those  parts  of  feder¬ 
ated  America,  called  the  New  England  States,  to  prevent,  by  various  legis¬ 
lative  provisions,  the  introduction  and  spread  of  small-pox  among  their 
citizens  in  the  natural  way,  and,  in  some,  by  inoculation.  In  consequence 
of  such  statutes,  it  was  many  years  customary  for  persons  in  New  England 
who  wished  to  have  the  small-pox,  to  come  to  New  York  for  the  purpose  of 
being  inoculated,  and,  after  their  recovery,  to  return  home.  There  was  an 
inconvenience  in  this,  but  this  was  thought  a  mere  trifle  compared  with  the 
evil  of  its  indiscriminate  introduction.  In  sea-port  towns,  possessing  a 
large  share  of  foreign  commerce,  it  had  been  found  impossible  to  exclude 
this  malady  altogether ;  and  in  spite  of  all  possible  precautions,  the  con¬ 
tagion  would,  at  certain  times,  be  secretly  introduced.  To  relieve  them¬ 
selves,  in  some  degree,  from  the  perpetual  anxiety  of  having  the  small  pox 
spread  among  them  in  the  natural  way,  the  inhabitants  of  the  town  of  Bos¬ 
ton  underwent  a  general  inoculation,  by  common  consent. 

Dr.  Benjamin  Waterhouse,  of  Boston,  who  had  previously  published  an 
instructive  account  of  the  various  regulations  concerning  small-pox  inocu¬ 
lation,  was  the  first  to  describe  to  and  urge  upon  his  fellow  citizens  ot  New 
England,  the  great  discovery  of  Edward  Jenner. 


INTRODUCTION  OF  VACCINATION  INTO  THE  NEW-ENGLAND 
STATES,  MORE  ESPECIALLY  INTO  BOSTON,  MASSACHU¬ 
SETTS  BY  DR.  WATERHOUSE, 

Early  in  the  year  1799,  Dr.  Jenner’s  work  on  the  variola  vaccine  reached 
the  shores  of  North  America. 

Dr.  Lettsom  transmitted  a  copy  of  it  to  Dr.  Waterhouse,  Professor  of 
the  Theory  and  practice  of  Physic  in  the  University  of  Cambridge,  Massa¬ 
chusetts.  Dr.  Waterhouse  was  not  slow  to  estimate  the  advantage  of  the 


Introduction  of  Vaccination  into  the  New  England  States. 


181 


discovery,  and  he  published  in  the  Columbian  Sentinel  of  March  12,  1799, 
a  short  account  of  cow-pox.  The  article  was  headed  “Something  Curious 
in  the  Medical  Line.”  Not  long  afterwards  he  brought  the  subject  be¬ 
fore  the  American  Academy  of  Arts  and  Sciences.  John  Adams,  President 
of  the  United  States,  who  was  likewise  President  of  the  Academy,  was  at 
the  meeting’  and  received  the  communication  in  a  manner  worthy  of  his 
exalted  position  as  the  head  of  a  great,  and  free  people,  and  the  patron  of 
every  useful  art  and  science. 

After  Several  unsuccessful  attempts  to  obtain  cow-pox  matter  from  Eng¬ 
land,  Dr.  Waterhouse  at  length  succeeded  in  getting  some  from  Dr.  Hay- 
garth,  of  Bath,  who  forwarded  it  from  Bristol.  It  was  procured  from  Dr. 
Jenner’s  stock  by  Mr.  Creaser.  With  this  matter  Dr.  Waterhouse  inocu¬ 
lated  seven  of  his  children,  six  of  whom  went  through  the  disease  in  the 
usual  manner.  In  order  to  confirm  the  doctrine  of  the  prophylactic  powers 
of  the  vaccine  virus,  he  resolved  to  have  his  children  inoculated  with  small¬ 
pox  matter  in  the  most  public  manner.  With  this  intention,  he  wrote  to 
Dr.  Aspinwall,  Physician  to  the  Small  pox  Hospital  in  the  neighborhood  of 
Boston,  requesting  him  to  inoculate  the  children.  This  gentleman  assented 
to  the  proposal.  Three  of  the  children  were  sent  to  the  Small-pox  Hos¬ 
pital.  One  of  them,  twelve  years  old,  was  selected  for  the  trial.  Active 
small-pox  matter  was  inserted  by  two  punctures  ;  an  infected  thread  was 
likewise  drawn  through  the  skin,  and  the  patient  then  left  in  the  hospital. 
On  the  fourth  day  there  was  some  slight  appearance  of  infection ;  but  it 
died  away  and  left  no  traces  of  its  action. 

The  successful  vaccinations  in  the  family  of  Dr.  Waterhouse  soon  turned 
the  tide  of  popular  feeling  in  favor  of  cow-pox. 

A  vessel  arrived  from  London  at  Marblehead.  A  common  sailor  on  board 
was  supposed  to  have  the  cow-pox.  Matter  was  accordingly  taken  from 
him,  and  was  used  extensively.  It  was  soon  discovered  that  small  pox 
matter  had  been  employed,  and  that  disease  spread  rapidly  through  the 
neighborhood. 

The  occurrence  at  Marblehead  led  Dr.  Waterhouse  to  believe  that  the 
vaccine  virus  had  degenerated.  He  therefore  sent  a  very  urgent  request  to 
Dr.  Lettsom,  begginghim  to  apply  to  Dr.  Jenner  for  a  fresh  supply.  Dr. 
Jenner  complied  with  his  request,  and  the  matter  which  he  sent  out  arrived 
early  in  the  spring  of  1801.  Dr.  Waterhouse  forwarded  some  of  the  mat¬ 
ter  to  President  Thomas  Jefferson,  in  whose  hands  it  completely  succeeded. 

Thomas  Jefferson  did  not  think  it  beneath  him  to  set  an  example  to  his 
fellow-citizens.  In  the  course  of  July  and  August,  Jefferson,  with  his  son- 
in-law,  vaccinated,  in  their  own  families  and  in  those  of  their  neighbors, 
nearly  two  hundred  persons. 

The  estimate  in  which  Mr.  Jefferson  held  the  discovery  of  Dr.  Jenner,  is 
shown  by  the  following  letter: 

MR.  JEFFERSON  TO  DR,  JENNER. 

Monticello,  Virginia,  May  14,  1806. 

Sir — I  have  received  the  copy  of  the  evidence  at  large,  respecting  the 
discovery  of  the  vaccine  inoculation,  which  you  have  been  pleased  to  send 
me,  and  for  which  I  return  you  my  thanks.  Having  been  among  the  early 
converts  of  this  part  of  the  globe  to  its  efficacy,  I  took  an  early  part  in 
recommending  it  to  my  countrymen.  I  avail  myself  of  this  occasion  to 
render  you  my  portion  of  the  tribute  and  gratitude  due  to  you  from  the 
whole  human  family.  Medicine  has  never  before  produced  any  single  im¬ 
provement  of  such  utility.  Harvey’s  discovery  of  the  circulation  of  the 
blood  was  a  beautiful  addition  to  our  knowledge  of  the  ancient  economy; 


182 


Introduction  of  Vaccinnation  into  the  New  England  States. 


bat  on  a  review  of  the  practice  of  medicine  before  and  since  that  epoch,  I 
do  not  see  any  great  amelioration  which  has  been  derived  from  that  dis¬ 
covery.  You  have  erased  from  the  calendar  of  human  afflictions  one  of 
its  greatest.  Yours  is  the  comfortable  reflection  that  mankind  can  never 
forget  that  you  have  lived;  future  nations  will  know  by  history  only  that 
the  loathsome  small-pox  has  existed,  and  by  you  has  been  extirpated. 
Accept  the  most  fervent  wishes  for  your  health  and  happiness,  and  assur¬ 
ances  of  the  greatest  respect  and  consideration. 

TH.  JEFFERSON. 

The  following  Extract  from  a  letter  of  Jefferson  addressed  to  Dr.  Water- 
house,  illustrates  the  careful  manner  in  which  he  studied  the  progress  and 
varieties  of  the  cow-pox. 

“Washington,  January  14,  1802. 

“  1  have  waited  till  I  could  inform  you  that  some  variolous,  after  vac¬ 
cine,  inoculations  have  proved  that  1  had  preserved  the  matter  of  the 
kine-pox  in  its  genuine  form.  Dr.  Coxe,  of  Philadelphia,  has  ascertained 
this,  having  received  his  matter  from  hence.  To  this  is  added  your  in¬ 
formation  that  the  matter  I  sent  you  produced  the  genuine  disease,  and 
consequently  those  in  Virginia  who  received  the  matter  from  me  are  in  se¬ 
curity. 

“  Knowing  how  little  capable  the  people  in  general  are  of  judging  be* 
tween  genuine  and  spurious  matter  from  their  appearance,  or  that  of  the 
sore,  I  endeavored  in  the  course  of  inoculations  at  Monticello  to  find  some 
other  criterion  for  their  guide.  With  this  view,  I  was  very  attentive  to 
discern  whether  there  be  not  a  point  of  time ,  counting  from  vaccination, 
when  the  matter  is  genuine  in  all  cases;  I  thought  the  eight  times  twenty  - 
four  hours  furnished  such  a  point ;  I  governed  myself  by  it,  and  it  has 
been  followed  here  successfully  by  Dr.  Gant ;  but  your  experience  is  so  much 
greater,  can  inform  us  whether  this  rule  is  a  sure  one,  or  whether  any  other 
point  of  time  would  be  still  more  certain.  To  the  eye  of  experience  this 
is  not  necessary;  but  for  popular  use  it  would  be  all  important ;  for  other¬ 
wise  the  disease  degenerates  as  soon  as  it  gets  into  their  hands,  and  may 
produce  a  fatal  security.  I  think  some  popular  criterion  necessary  to 
crown  this  discovery.” 

In  answer  Dr.  Waterhouse  quoted  to  Jefferson,  the  opinion  of  Dr.  Jen- 
ner,  and  fixed  the  time  at  “  Eighth  Times  Twenty-four.  Hours.” 

JOHN  QUINCY  ADAMS  TO  DR.  JENNER. 

Boston,  July  13, 1802. 

The  following  is  the  letter  of  Mr.  Adams  announcing  the  election  of  Dr. 
Jenner  as  a  member  of  the  American  Academy  of  Arts  and  Sciences. 

Sir — I  have  the  honor  of  enclosing  herewith  a  certificate  of  your  election, 
by  an  unanimous  vote,  as  a  member  of  the  American  Academy  of  Arts  and 
Sciences,  and,  in  transmitting  this  testimonial  of  respect  from  my  country¬ 
men,  I  am  sure  of  expressing  their  sentiments  when  I  add  that  never  since 
the  institution  of  this  society  have  its  members  enjoyed  a  more  genuine  and 
universal  satisfaction),  by  the  accession  of  a  new  associate,  than  when  they 
acquired  the  privilege  of  reckoning  among  their  number  the  name  of  Dr. 
Jenner.  I  am,  very  respectfully,  sir,  your  very  humble  and  obedient  servant, 

JOHN  QUINCY  ADAMS. 

Corresponding  Secretary  to  the  Academy  of  Arts  and  Sciences. 


Introduction  of  Vaccination  into  tlie  Southern  States. 


183 


Dr.  Benjamin  Waterhouse*  is  justly  regarded  as  the  first  person  in  Amer¬ 
ica  who  successfully  imported  and  inoculated  the  vaccine  disease;  and  his 
exertions  to  introduce,  disseminate  and  vindicate  this  inestimable  substi¬ 
tute  for  the  small-pox,  have  given  him  a  just  and  elevated  distinction 
among  those  who  have  signalized  their  zeal  in  the  cause  of  humanity. 


INTRODUCTION  OF  VACCINATION  INTO  THE  SOUTHERN 
STATES,  BY  THOMAS  JEFFERSON,  OF  VIRGINIA. 

In  the  preceding  observations  upon  the  history  of  vaccination  in  the 
New  England  States,  we  have  presented  the  outline  of  the  efforts  of  Water- 
house  and  Jefferson  to  establish  the  value  and  promote  the  practice  of  vac¬ 
cination  amongst  the  citizens  of  the  American  Union. 

The  subject,  however,  is  of  such  importance  to  sanitarians,  physicians 
and  legislators,  that  we  record  the  following  original  documents,  as  given 
to  the  medical  profession  by  Dr.  Henry  A.  Martin,  in  his  valuable  memoir, 
entitled,  “ Jefferson  as  a  V accinatorV t 

The  first  American  vaccination  was  made  July  8,  1800.  By  the  first  of  September 
Waterhouse  had  vaccinated  “about  fifty  persons  of  different  ages,  sexes  and  conditions,” 
and  “public  attention  was  thoroughly  excited.”  From  “all  parts  of  New  England”  he 
received  “very  numerous  letters  requesting  further  information,  as  well  as  a  supply  of 
matter  for  carrying  on  the  inoculation.” 

With  Waterhouse’s  announcement  of  the  successful  vaccination  of  his  family,  and  the 
thorough  and  triumphant  test  and  proof  of  its  value  as  a  perfect  prophylactic  of  variola, 
liia  labors  and  troubles  began  ;  labors  and  troubles  to  be  continued  through  many  years, 
utterly  thankless  and  unrewarded,  but  performed  and  overcome  with  wonderful  energy, 
enthusiasm  and  wisdom.  Innumerable  were  the  inquiries  and  demands  for  vaccine  virus, 
and,  although  he  was  untiring  in  his  efforts,  innumerable  the  complaints,  because  all 
were  not  answered  and  every  demand  not  immediately  gratified. 

*In  the  securnr  press,  in  the  rarely  appearing  issues  of  medical  journals,  in  every  avail¬ 
able  way  he  ceaselessly  cautioned  the  profession  to  be  careful  to  follow  exactly  the  pre¬ 
cise  and  admirable  rules  laid  down  by  Jenner,  not  one  of  which  has  failed  to  withstand 
the  test  of  time,  or  to  survive  the  antagonistic  doctrines  of  innumerable  theorists.  Over 
and  over  again,  he  repeated,  and  enforced  the  repetition  with  much  ability  and  eloquence 
that  inestimable  “Golden  Rule”  of  Jenner  already  referred  to;  adhering  to  which,  ex¬ 
actly,  one  can  hardly  go  amiss,  and  departing  whence  has  been  the  fertile  source  of  an 
incalculable  amount  of  evil. 

It  is  not  too  much  to  say,  that,  with  a  precise  and  accurate  knowledge  of  the  develop¬ 
ment,  from  day  to  day,  of  the  vesicle  of  true  vaccina,  uot  only  from  its  first  appearance 
to  the  formation  of  the  areola,  but  from  the  decline  of  that  efflorescence  until  the  spon¬ 
taneous  fall  of  the  scab,  and  of  the  true  characteristics  of  the  latter  as  well  as  of  the 
scar  which  its  fall  reveals,  and  an  inflexible  determination  to  observe  the  “Golden 
Rule,”  the  practitioner  possesses  all  the  knowledge  and  principle  necessary  to  make  a 
successful  and  intelligent  vaccinator. 

Waterhouse’s  cautions  and  labors  were  unheeded,  misjudged  and  futile. 

In  his  words:  “  But  these  repeated  cautions  were  disregarded  by  the  young  and  san¬ 
guine  practitioner,  who  saw  nothing  but  regular  cases,  little  ti’ouble  and  great  profits. 
If  those  whom  it  concerns  will  not  attend  to  what  is  written  expressly  for  their  inform¬ 
ation,  they  must  alone  be  answerable  for  the  consequences.  There  are  cases  where  igno¬ 
rance  is  converted  into  a  crime. 

*  A  Prospect  of  Exterminating  the  Small-pox,  being  the  History  ot  the  Variolas  Vaccinas  or  Kine-pox, 
commonly  called  the  Cow-pox,  as  it  has  appeared  in  England  ;  with  an  account  of  a  series  of  Inoculations 
performed  for  the  Kine-pox  in  Massachusetts  By  Benjamin  ‘Waterhouse,  M  I)  ,  Eellow  of  the  American 
Philosophical  Society,  Academy  of  Arts  and  Sciences,  etc.,  etc.  Cambridge,  Hilliard  ;  8  vo  ,  p.  40.  1800. 

A  Prospect  of  Exterminating  the  Small-pox.  Part  2.  Being  a  Continuation  of  a  Narrative  of  Pacts  con¬ 
cerning  the  Progress  of  the  New  Inoculation  in  America  ;  together  with  Practical  Observations  on  the  Local 
Appearance,  Symptoms,  and  M  ode  of  Treating  the  Variola?  Vaecinte,  or  Kiue-pock,  etc.  By  Benjamin  Wa¬ 
terhouse,  M.  1).,  Professor  of  the  Theory  and  Practice  of  Medicine  in  the  University  of  Cambridge.  8  vo., 
pp.  139;  Cambridge,  Hilliai-d  ;  1800.  , 

tNorth  Carolina  Medical  Journal.  Thomas  I).  Wood,  M.  D.,  Editor,  Wilmington,  January,  1881,  vol.  7, 
No.  1,  pp.  1-34. 

The  medical  profession  is  indebted  to  the  learned  editor  of  the  North  Carolina  Medical  Journal  for  the 
preservation  and  publication  of  valuable  articles  relating  to  vaccination. 


184 


Introduction  of  Vaccination  into  the  Southern  Shades. 


“  Perceiving  that  my  reiterated  warnings  were  misconceived  and  misrepresented,  and 
finding  some  professional  gentlemen  in  the  country  so  wrapt  op  in  ideas  of  extreme  sim¬ 
plicity,  that  they  encouraged  women  and  children  to  inoculate  each  other,  I  ceased  from 
further  expressions  of  that  kind,  and  endeavored  to  content  myself  with  predicting  the 
consequences. 

“  During  this  period,  viz  :  the  autumn  of  1800,  a  singular  traffic  was  carried  on  in  the 
article  of  kine-pock  matter ,  by  persons  not  in  the  least  connected  •with  the  medical  pro¬ 
fession  ;  such  as  stage-drivers,  peddlers,  and  iu  one  instance  the  sexton  of  a  church.  I 
have  known  the  shirt  sleeve  of  a  patient,  stiff  with  the  purulent  discharge  from  a  foul 
ulcer,  made  so  by  unskillful  management,  and  full  three  weeks  after  vaccination,  and  in 
which  there  could  have  been  none  of  the  specific  virus  ;  I  have  known  this,  cut  up  into 
small  strips,  and  sold  about  the  country  as  genuine  kine-pock  matter,  coming  directly 
from  me.  Several  hundred  people  were  inoculated  with  this  caustic  morbid  poison, 
which  produced  great  inflammation,  sickness,  fever,  and  in  several  cases  eruptions,  with 
a  greater  disturbance  of  the  system  than  what  occurs  in  the  true  disease.  It  is  worthy 
of  remark  that  I  could  not  influence  these  people  to  believe  that  they  had  not  passed 
through  the  true  disease,  and  that  they  were  not  secure  from  the  small-pox.  So  true  it 
is,  that  a  man  need  not  despair  of  making  the  common  people  believe  anything  but 
truth!  That  vagrant  quacks  should  stroll  about  the  country,  inoculating  for  half  a 
dollar  a  head,  and  some  for  less,  is  not  quite  so  surprising  as  that  they  should,  in  such  a 
country  as  ours,  find  people  weak  enough  to  receive  it  from  such  hands!  This  impru¬ 
dence  ought  not,  however,  to  be  attributed  to  the  common  people  alone.  Many  young 
practitioners  iu  country  villages  come  iu  for  a  share  of  it.  Not  a  few  first  inoculated 
themselves,  aud  then  oihers,  without  having  read  more  than  the  newspaper  publications, 
and  some  not  even  those,  and  were  looking  out  for  eruptions,  and  foretelling  appearauces 
and  symptoms  that  are  never  attached  to  the  disease  ;  and  if  any  very  disagreeable  oc¬ 
currence  arose,  in  the  course  of  this  imprudent  practice,  the  odium  reverted  to  me.” 

Following  this  is  given  a  narrative  of  the  terrible  catastrophe  resulting  from  all  this 
reckless,  ignorant,  presumptuous  tampering  with  a  new  and  as  yet  a  very  imperfectly 
known  practice,  at  Marblehead,  a  large  Massachusetts  town,  an  event  which  had  a  par¬ 
tial  parallel  at  Norfolk  and  Portsmouth,  in  Virginia,  and  in  other  parts  of  the  country. 
The  result  of  all  this  malpractice  aud  of  an  imperfect  knowledge  of  the  best  methods  of 
preserving  “ stored ”  vaccine  virus  was  extreme  aud  rapid  deterioiation,  and,  at  last,  en¬ 
tire  loss  of  the  first  supply  of  true  vaccine  lymph  in  America. 

“Very  early  in  the  spring  of  1801”  Waterhouse  received  “a  fresh  supply  of  virus  from 
England  from  Drs.  Lettsoni  and  Jeuner,  and  as  soon  after,  more  from  Dr.  Pearson,  Dr. 
Woodville,  Mr.  Ring,  Mr.  Wachsel,  Mr.  Kerre,  Sir  Granville  Temple  and  the  Vaccine  In¬ 
stitution  of  Loudon,  and  also  from  Dr.  Haygarth  and  Mr.  Creaser,  of  Bath,  and  Mr.  Dun¬ 
ning,  of  Plymouth  Dock.”*  “  Previous  to  this  second  importation,”  he  writes,  “I  had 
reason  to  believe  that  the  true  virus  had  become  extinct  in  America.  The  inoculation  was, 
however,  carried  on  here  and  there,  in  the  country,  with  such  matter  as  they  had.*’] 

Those  ample  supplies  were  used  immediately  with  prompt  and  perfect  success,  the  nar¬ 
rative  of  which  is  given  with  a  very  admirable  commentary  on  the  contrast  between  the 
regularity  and  mildness  of  the  development  of  the  true  and  protective  disease  in  contrast 
with  the  irregularity  aud  violence  of  the  phenomena  and  symptoms  of  that  totally  un- 
protective  spurious  disease,  apt  io  result  from  the  use  of  lymph  taken  from  the  vesicle 
alter  the  formation  of  the  areola  and  sure  to  follow  the  inoculation  of  decomposed  or  de¬ 
composing  pus,  but  which  many  pf  Waterhouse’s  contemporaries,  who  misjudged  his 
motives  and  disregarded  lus  repeated  cautions,  had  pronounced  perfect  and  admirable 
developments  of  vaccina ,  h  II  this  is  extremely  interesting  and  might  be  republished  and 
pondered  even  now  with  profit.  The  disasters  and  innumerable  annoyances  accompany 
the  use  and  great  abuse  of  the  first  importation  of  efficient  virus  determined  Waterhouse 
to  exercise  the  greatest  caution  iu  selecting  those  to  whom  he  should  distribute,  what  he 
calls  the  “second  importation”  of  virus. 

Vaccination  had  not  yet  been  introduced  into  the  Southern  States,  but,  in  his  own 
words : 

About  this  time  (the  spring  of  1801)  I  received  a  number  o  f  letters  from  a  variety  of 
people  in  the  Southern  States,  especially  from  Virginia,  expressing  a  strong  wish  to  be 
better  acquainted  with  the  kine-pock,  and  a  desire  to  introduce  this  benign  remedy  into 

*1  have  given  Waterhouse’s  long  list  of  English  physicians  and  institutions  supplying  this  "second  im¬ 
portation”  of  virus,  merely  to  illustrate  the  great  extent  of  his  European  correspondence,  as  affording,  too, 
slight  indication  of  the  arduous  nature  of  his  labors,  as  a  missionary  of  vaccination,  by  those  who  were, 
above  all  others,  competent  to  criticise  and  judge. 

tThe  italics  are  mine.  The  employment  of  dubious  vaccine  virus,  in  the  absence  of  any  State  or  public 
institution  whence  perfectly  reliable  and  gratuitous  supplies  might  be  always  obtained,  on  a  sort  of  theory  • 
any  false,  in  vaccination  at  any  rate,  that  a  poor  remedy,  or  rather  pretence  of  remedy,  is  better  than  none 
at  all,  has  always  been  one  of  the  great  evils  of  America,  and  the  cause  directly  of  a  vast  amount  of  imper¬ 
fect  or  quite  illusory  protection  11  protection,”  aud  indirectly,  both  by  failure  to  afford  immunity  from  small¬ 
pox  and  by  the  production  of  “bad  arms”  (the  “loathsome  hideous  eating  ulcers,”  “running  sores,”  “dis* 
gustiug  eruptions,”  etc.,  of  the  autri-vaccinists)  very  serious  injury  to  the  cause  aud  reputation  of  vaccina¬ 
tion  in  this  country. — H.  A.  M. 


Introduction  of  Vaccination  into  the  Southern  States. 


185 


that  extensive  region.  As  most  of  the  writers  were  entirely  unknown  to  me,  I  was  at  a 
loss  how  to  act.  I  might  deny  a  physician  of  character,  and  I  might  entrust  it  to  a  per¬ 
son  who  had  none.  Some  untoward  occurrences  in  the  past  year  rendered  me  cautious  ; 
for  I  had  unknowingly  encouraged  mere  speculators.  I  use  that  word  in  its  modern  aud 
degenerate  sense.  While  doubting  what  course  to  take,  the  right  road  opened  to  my 
view. 

“  I  had  heard  that  President  Jefferson  was  favorably  impressed  by  my  first  annuncia¬ 
tion  of  the  Jennerian  discovery  and  practice.  Indeed,  the  following  letter,  written  in 
consequence  of  transmitting  him  a  copy  of  my  pamphlet  on  this  subject,  sufficiently  tes¬ 
tifies  it : 

Washington,  December  25,  1800. 

“  Sir — I  received  last  night,  and  have  read  with  great  satisfaction,  your  pamphlet  on 
the  subject  of  the  kine-pock,  aud  pray  you  to  accept  my  thanks  for  the  communication 
of  it. 

“  I  had  before  attended  to  yonr  publications  on  the  subject  in  the  newspapers,  and  cook 
much  interest  in  the  result  of  the  experiment  you  were  making.  Every  friend  of  hu¬ 
manity  must  look  with  pleasure  on  this  discovery,  by  which  one  evil  more  is  withdrawn 
from  the  condition  of  man  ;  and  must  contemplate  the  possibility,  that  future  improve¬ 
ments  and  discoveries  may  still  more  and  more  lessen  the  catalogue  of  evils.  In  this  line 
of  proceeding  you  deserve  well  of  your  country  ;  and  I  pray  you  accept  my  portion  of  the 
tribute  due  to  you,  and  assurances  of  high  consideration  and  respect,  with  which  I  am 
sir,  your  most  obedient,  humble  servant,  ‘  “THOMAS  JEFFEKSON.’ ” 

[Copy.] 

Dr.  Waterhouse,  Cambridge.* 

“  Hearing  by  some  gentlemen  direct  from  the  seat  of  government  that  the  President 
wished  for  still  more  information  and  that  he  was  desirous  to  see  the  practice  introduced 
into  Virginia  and  the  other  Southern  States,”  Waterhouse  “sent  him  the  vaccine  virus 
and  painted  representations  of  the  pustulet  in  all  its  stages  on  the  white  man  and  on  the 
African.”  This  precious  package  was  accompanied  by  a  long  (seven  pages  in  Water¬ 
house’s  book)  letter,  excellently  written  and  giving  a  masterly  resume  of  the  whole  sub¬ 
ject  of  vaccination.  A  foot  note  informs  us  that  this  letter  was  repeated  in  many  manu¬ 
script  copies  which  were  widely  circulated  “at  the  southward”  and  it  doubtless  con¬ 
tained  the  first  reliable  information  on  that  subject  received  by  many  a  Southern  practi¬ 
tioner.  Although  this  letter  could  hardly  fail  to  interest  Southern  physicians,  it  would 
occupy  too  much  space  in  a  paper  which  has  already  far  exceeded  limits  originally  in¬ 
tended. 

The  following  is  Jefferson’s  answer.  At  tlie'bottom,  a  note  intimating  that  Jefferson’s 
first  letter  had  been  considered  a  precious  and  grateful  tribute  to  Jennet  and,  as  such  had 
been  transmitted  to  him,  is  in  the  writing  of  Waterhouse  : 

Washington,  June  26,  1801. 

Your  favor  of  the  eighth  instant  came  safely  to  hand  with  the  several  matters  accom¬ 
panying  it;  as  the  longer  the  vaccine  matter  should  be  unemployed.  I  knew  the  chance 
of  its  success  would  be  the  less.  I  thought  it  would  be  more  likely  to  ausweryour  benevo- 

*Tliis  is  the  letter  which,  as  a  note  on  the  margin  of  the  second  letter  (the  first  facsimile  in  the  hand 
writing  of  Waterhouse  informs  us  was  sent  to  Jenner,  and,  of  course,  it  is  not  to  be  found  in  series  of  fac¬ 
similes. 

t  “Pustule” — Waterhouse,  here  and  elsewhere,  uses  the  word  “pustule"  in  describing  the  induced  erup¬ 
tion  of  vaccina ,  rather  than  to  appear,  with  what  might  be  called,  captiousmess,  to  differ  from  Jenner  and 
other  English  writers.  The  eruption  of  vaccina  is  not  a  pustule  at  any  stage  of  its  development.  When 
the  disease  pursues  a  regular  normal  typical  course,  pus  is  never  discoverable  in  tjje  vesicle.  After  the 
formation  of  the  areola  pus  exists  in  the  tissues  outside  the  vesicle  as  an  accompaniment  of  the  processes  by 
which  the  cutaneous  slough  of  which  the  crust  is  (with  the  desicated  lymph)  composed  is  cast  off  and  the 
.  characteristic  indellible  scar  is  produced.  Waterhouse  knew  this  perfectly,  as  is  evident  from  the  following 
foot  note  to  page  f>,  of  the  second  part  of  his  “  Prospect  of  Exterminating  the  Small-Pox :  “By  the  pustule , 
the  British  writers  mean  the  circular  sore,  or  vesicle  made  in  the  arm  by  inoculation;  and  not  those  erup¬ 
tions,  that  have,  in  a  few  instances,  appeared  in  places  remote  from  the  inoculated  part  This  difference  in 
our  phraseology  has  misled  some  among  us.  It  ought  not,  strictly  speaking,  to  be  called  pustule,  until  its 
contents  have  become  purulent.  The  eruptions  on  the. udder  of  the  cow  are  more  of  phylctine  than  of  the 
purulent  kind.”  It  may  be  usefully  added  that  pus  may  appear  in  the  vesicle,  when  it  does  it  is  as  a  result 
of  injury  or  other  causes  and  resulting  inflammation  and  deterioration  but  this  is  not  the  regular  normal  or 
usual  course,  such  a  contaminated  fluid  is  not  tit  to  use  for  vaccination,  but  this  fluid,  a  mixture  of  vaccine 
virus  and  pus,  lias  been  used  times  without  number  and  even  pus,  quite  unmixed  with  virus.  We  cau  well 
see  how  easily,  by  men,  who  regarded  the  vesicle  as  &  pustule,  a  something  normally  secreting  pus,  and  those 
who  adopted  the  views  of  Coxe  and  others  and  collected  material  for  their  inoculations  (they  could  not 
properly  be  called  vaccinations)  from  the  site  of  the  vesicle  so  long  as  that  site  yielded  or  could  he  compelled 
to  yield  a  fluid  of  almost  any  kind.  The  fact,  for  it  is  a  fact,  that  a  normal  perfect  vaccine  scab  is  very  sure 
to  afford  material  for  perfect  vaccination  was  thought  by  Coxe  and  his  s'chool  (whose  name  was  and  is 
Legion)  to  triumphantly  demonstrate  the  position  that  the  above  practice  is  quite  free  from  objection.  It 
would  he  extremely  easy  to  exhibit  the  fallacy  of  this  supposed  proof  and  show  that  while  a  perfect  typic  a 
vaccine  crust,  from  a  healthy  vaccinifer,  generally  affords  excellent  material  for  vaccination  fluid  taken  from 
any  vaccine  vesicle  after  the  decline,  even  after  the  full  formation  of  the  areola  is  extremely  apt  to  be  the 
verv  worst  and  although  such  fluid  may  and  often  does  induce  perfect  vaccina ,  it  should  be  always  declined. 

H.  A.M. 


Introduction  of  Vaccination  into  the  Southern  States. 


186 


lent  views  by  having  it  e  nployecl  here  rather  than  by  risking  it  by  a  further  mission  to 
Virginia.  I,  therefore,  put  it  immediately  into  the  bauds  ol  Doctor  Gantt,  a  long  estab¬ 
lished,  judicious  and  successful  physician  of  this  place,  together  with  your  letter  and 
the  pamphlets  and  papers  accompanying  it.  It  turns  out  that  it  had  still  been  too  long 
unemployed  ;  for  of  numbers  inoculated  with  it  from  the  thirteenth  to  this  time,  no 
one  appears  to  have  taken  the  infection.  In  the  meantime  a  great  anxiety  is  pro¬ 
duced  here  to  obtain  a  successful  inoculation.  I  know  not,  however,  how  it  will  be  ob¬ 
tained,  unless  you  could  continue  your  goodness  so  far  as  to  inclose  by  post  new  matter 
two  or  three  times  successively  until  we  can  inform  you  that  it  has  at  length  taken.  You 
need  not  be  at  the  trouble  of  writing  a  word,  for  it  is  making  it  troublesome  enough  to 
you  to  put  the  matter  under  cover  and  into  the  postoffice.  The  benevolence  which  has 
dictated  the  measures  for  which  we  are  indebted  to  you,  will,  I  hope,  plead  my  excuse 
on  this  new  request.  I  pray  you  to  accept  assurances  of  m y  high  consideration  and  re¬ 
spect.  '  TH.  JEFFERSON. 

N.  B. — The  first  letter  I  received  from  Mr.  Jefferson  was  dated  December  29,  1800.  It 
is  printed  m  my  Treatise,  p.  2.  I  sent  the  original  a  present  to  Dr.  Jenner,  thinking,  that 
coming  from  the  Chief  Magistrate  of  the  Americans,  it  would  not  be  unpleasing  to  the 
originator  of  vaccination. 

Doctor  Benjamin  Warehouse. 

The  next  letter  informs  Dr.  Waterhouse  that  not  only  the  first,  but  also  a  second  sup¬ 
ply  of  virus  had  failed,  but  expresses  hope  that  the  third  will  be  more  successful.  This 
hope  was  to  prove  fallacious.  The  letter  contains  an  original  and  excellent  suggestion  of 
Mr.  Jefferson's  for  the  preservation  of  virus  in  hot  weather.  It  may  be  worth  while  to 
state  that  the  present  writer  thought  he  had  invented  the  same  plan  which  he  found 
very  useful  in  the  summer  of  1872.  He  procured  the  manufacture  of  several  hundred 
sets  of  glass  vessels,  similar  to  test-tubes,  for  distribution  to  his  correspondents.  Each 
set  consisted  of  one  vessel  to  contain  the  charged  points  and  a  larger  one  containing 
water  in  which  the  smaller  vessel  was  enclosed.  He  spoke  with  considerable  compla¬ 
cency  of  his  invention  for  a  month  or  two,  only,  at  the  end  of  time,  to  find  that  Mr.  Jef¬ 
ferson  was  the  inventor.  This  experience  of  the  method  convinced  him  that  it  is  a  good 
one  and  worthy  of  the  recollection  of  practitioners  wishing  to  keep  virus  from  deterio¬ 
ration  under  certain  circumstances,  as  for  instance,  on  the  office  table  during  hot 
weather.  It  will  be  perceived  that  a  small  bit  of  this  letter  lias  been  lost.  There  is  no 
doubt  the  letters  “tre”  formed  part  of  the  w'ord  treatise,  or  that  the  reference  is  to  a 
now  quite  rare  pamphlet  by  Dr.  J.  C.  Lettsom,  entitled,  “  Observations  on  the  Cow- 
Pock,  London,  1801,”  a  work  principally,  noticeable  for  the  portraits  it  contains  of  the 
four  men  then  fully  recognized  as  the  leaders  in  the  great  innovation  of  vaccination, 
viz:  Jenner,  Pearson,  Woodville  and  Waterhouse.  The  author  believes  the  portrait  of 
the  latter  and  a  poor  reproduction  of  the  same  in  the  Boston  Volxjanthos ,  for  May,  1806, 
to  be  the  only  engraved  likenesses  ever  produced  of  a  man,  of  whom,  if  men  saw  lit  to 
thus  honor  their  benefactors  and  saviors,  rather  than  their  disturbers  and  destroyers,  the 
features  would  be  perpetuated  in  “everlasting  bronze”  in  every  city  of  America. 

A  marginal  note  in  the  handwriting  of  Waterhouse  and  signed  with  his  initials  will 
be  noticed. 

Washington,  July  25,  1801. 

Bear  Sir — Your  favor  of  the  seventeenth  arrived  last  night,  together  with  the  new  vac¬ 
cine  matter,  which  was  immediately  sent  to  Doctor  Gantt.  The  second  as  well  as  the 
first  supply  of  matter  had  failed.  We  hope  the  third  will  be  more  successful.  How 
might  it  answer^to  put  the  matter  into  a  phial  of  the  smallest  size,  well  corked,  and  im¬ 
mersed  in  a  larger  one  tilled  with  water  and  well  corked.  It  would  be  effectually 
preserved  against  the  air,  and  I  doubt  whether  the  water  would  prevent  so  great  a  de¬ 
gree  of  heat  to  penetrate  to  the  inner  vessel  as  does  when  it  is  in  the  open  air.  It  would 
get  cool  every  night,  and  shaded  every  day  under  the  cover  of  the  stage,  it  might  per¬ 
haps  succeed.  I  leave  this  place  on  the  thirtieth  instant  for  Monticello,  being  unwilling 
to  risk  myself  on  the  tidewaters  during  the  months  of  August  and  September.  The  sit¬ 
uations  which  generate  bilious  complaints  are  most  dangerous;  my  owu  is  entirely  ex¬ 
empt  from  that  danger.  Should  you  be  so  good  as  to  continue  forwarding  matter  till  it 
succeeds,  it  will  now  be  best  to  address  the  packages  to  Dr.  Gantt,  from  whom,  so  soon 
as  he  succeeds,  I  shall  ask  a  transmission  of  fresh  matter  to  Monticello",  where  I  shall 
endeavor  to  introduce  it.  It  will  be  a  great  service,  indeed,  rendered  to  human  nature 
to  strike  oil  from  the  catalogue  of  its  evils  so  great  a  one  as  the  small-pox.  1  know  of 
no  one  discovery  in  medicine  equally  valuable.  Accept  assurances  of  my  great  esteem 
and  respect.  THOMAS  JEFFERSON. 

P.  S.  I  re-endorse  Doctor  Letsom’s  treatise. 

Doctor  Benjamin  Waterhouse. 


The  matter  sent  agreeably  to  this  direction  was  the  first  that  succeeded. 


Introduction  of  Vaccination  into  the  Southern  States. 


187 


The  fourth  letter  acknowledges  receipt  of  a  further  supply  of  virus,  aud  refers  to  the 
terror  with  which  small-pox  was  regarded  iu  Virginia: 

Monticello,  August  3,  1801, 

Dear  Sir — I  had  the  pleasure  of  writing  you  on  the  twenty-fifth  of  July,  acknowledging 
the  receipt  of  yours  of  July  17,  with  the  vaccine  matter,  which  I  immediately  de¬ 
livered  to  Doctor  Gantt.  Your  favors  of  the  twenty-fourth  and  twenty-fifth,  sent  to  me 
at  this  place  on  the  sixth  instant,  and  the  matter  accompanying  them  was,  by  a  skillful 
physician  of  the  neighborhood,  Dr.  Wardlow,  immediately  inserted  into  six'  persons  of 
my  own  family.  We  shall  thus  stand  a  chance  of  planting  the  disease  here,  where  I  im¬ 
agine  it  will  be  as  salutary  as  anywhere  in  the  Union.  Our  laws  indeed  have  permitted 
inoculation  of  the  small-po^,  but  under  such  conditions  of  consent  of  the  neighborhood 
as  have  admitted  of  not  much  use  of  the  permission.  That  disease,  therefore,  is  almost 
a  stranger  here  and  extremely  dreaded.  Will  take  car  eto  inform  you  of  the  result  of  our 
operation  Accept  my  esteem  and  respect.  THOMAS  JEFFERSON. 

Doctor  Benjamin  Waterhouse. 

The  fifth  ietter  refers  to  still  further  receipts  of  virus  and  the  use  that  was  made  o; 
them,  and  also  to  two  vaccinatious  made  on  the  seventh  of  August  which  exhibited 
symptoms  leading  the  writer  to  hope  that  success  had  been,  at  last,  achieved. 

Monticello,  August  14.  1801. 

Dear  sir — I  wrote  you  on  the  eighth  instant  that  your  favors  of  July  24  and  26  had  come 
to  me  here.  Dr.  Wardlow  on  the  seventh  inoculated  two  persons  with  the  matter  of  the 
twenty-fourth  and  four  with  that  of  the  twenty-sixth,  the  latter  has  no  effect,  but  the. 
two  former  show  inflammation  and  matter.  Some  of  them  complain  of  pain  under  the 
arm-pit,  and  yesterday  was  a  little  feverish  ;  the  matter  is  of  this  size  and  form  - ; 
the  inflammation  about  an  inch  all  round  from  the  pustule.  We  have  considerable  hopes 
he  has  the  true  infection.  Yesterday  I  received  your  favor  of  the  first  instant;  Dr.  Ward- 
low  immediately  inoculated  five  of  the  former  subjects  with  it,  and  one  other;  he  also  in¬ 
oculated  one  from  the  pustule  above  described.  You  shall  be  regularly  informed  of  the 
progress  and  suecess  of  this  business.  I  learn  from  Washington,  indirectly,  that  Dr 
Gantt’s  cases  have  all  failed;  should  ours  succeed,  he  sha’l  be  supplied  hence.  I  am  very 
anxious  to  obtain  the  disease  here.  Accept  my  best  esteem  and  respectful  salutations. 

TH.  JEFFERSON. 

Dr.  Benjamiu  Waterhouse. 

The  next  letter  announces  the  undoubted  success  with  which  all  three  different  lots  of 
virus,  transmitted  by  Mr.  Jefferson's  method,  had  been  employed. 

Monticello,  August  21,  1801. 

Dear  Sir — I  had  the  pleasure  of  informing  you  on  the  fourteenth  instant,  that  I  sup¬ 
posed  Hie  inoculation  of  the  kine-pox  to  have  taken  effect  in  two  subjects,  these  were 
from  the  matter  you  were  kind  euougli  to  send  July  24  ;  that  of  July  26  succeeded  with 
two  others;  that  of  August  1,  with  four.  On  the  fifteenth  instant,  we  inoculated  from 
the  two  first  subjects,  fifteen  others;  fourteen  of  whom  very  evidently  have  the  infection, 
so  that  we  have  twenty  of  mv  family  on  whom  the  disease  has  taken,  besides  some  recent 
inoculations;  some  of  them  have  slight  fevers,  headache,  kernels  under  the  arms,  and 
one  only  has  a  very  sore  arm  ;  most,  however,  experience  no  inconvenience,  aud  have 
nothing  but  the  inoculated  pustule,  well  defined,  moderately  filled  with  matter  and  hol¬ 
low  in  the  centre.  I  have  this  day  impregnated  some  thread  and  half  a  dozen  toothpicks, 
which  I  forward  to  Dr.  Gantt,  who  writes  me  that  his  inoculations  all  failed  Dr.  Ward- 
low,  of  this  neighborhood,  has  so  much  other  business,  that  he  has  been  able  to  be  with 
us  only  twice,  however,  I  expect  that  the  extent  of  my  experiments  will  encourage  the 
neighborhood  generally.  Engage  him  to  introduce  it  in  their  families. .  To  you  they  will 
be  indebted  for  it,  and  I  am  sure  they  will  be  sensible  of  the  obligation.  Accept  assur¬ 
ances  of  my  great  esteem  and  respect. 

TH.  JEFFERSON. 

Dr.  Benjamin  Waterhouse. 

Number  seven  announces  the  successful  use  in  Washington,  of  virus  sent  there  by 
Jefferson,  the  transmission  of  supplies  to  Richmond,  Petersburg  and  other  parts  of  Vir¬ 
ginia,  refers  slightly  to  certain  futile  and  disastrous  previous  attempts  to  introduce  vac¬ 
cination  in  Norfolk  and  Richmond  which  were  followed  by  results  similar  to  thsoe  ob¬ 
served  at  Marblehead  and  had  done  much  to  impede  the  introduction  and  progress  of 
true  vaccination  in  the  South,  also  to  a  proposed,  but  probably  never  executed  publica¬ 
tion  of  Dr.  Waterhouse’s  long  letter  of  instructions  before  alluded  to. 

Monticello,  September  17,  1801. 

Sir — I  received  by  the  last  post  your  favor  of  August  28,  and  by  the  same  a  letter  from 
Dr.  Gantt,  informing  me  that  the  matter  I  first  sent  him  from  hence  had  taken  on  three 
of  the  subjects  into  whom  it  had  been  inserted;  that  from  these  he  had  inoculated  others, 


188 


Introduction  of  Vaccination  into  the  Southern  States. 


so  that  they  are  now  in  foil  possession  of  the  disease  at  Washington.  I  have  also  sen  t 
matter  to  Richmond,  Petersburg  and  several  other  parts  of  this  State,  so  that  I  have  no 
doubt  it  will  be  generally  spread  through  it,  notwithstanding  the  incredulity  which  had 
been  produced  by  the  ineffectual  experiments  of  Richmond  and  Norfolk.  The  first  letter 
you  were  so  kind  as  to  write  to  me  on  the  subject,  and  which  contained  a  great  deal  of 
usefulinformation,  I  put  into  the  hands  of  Dr  Gantt,  and  we  concluded  it  would  be  use¬ 
ful  to  publish  it  as  soon  as  the  public  should  be  possessed  of  the  disease;  it  is  still  in 
his  hands,  and  as  you  have  been  so  kind  as  to  permit  us  to  make  any  use  of  it  which  the 
general  good  may  require,  I  shall  propose  to  him  to  have  it  published  immediately  on  my 
return  to  Washington,  which  will  be  within  a  week  from  this  time.  It  is  just  our  coun¬ 
trymen  should  know  to  whose  philanthropic  attentions  they  will  be  indebted  for  relief 
from  a.  disease  which  has  always  been  the  terror  of  this  country.  Accept  my  particular 
thanks  for  the  great  good,  and  assurances  of  mv  high  esteem  and  respect 

TH.  JEFFERSON. 

Dr.  Waterhouse: 

The  eighth  letter  is  a  very  interesting  one,  and  affords  a  good  idea  of  the  care  and  wis' 
dom  with  which  Jefferson  proceeded  in  this  whole  matter.  It  refers  to  the  supply  of 
virus,  from  his  own  Virginia  vaccinations  sent  (through  Mr.  John  Vaughn)  to  Dr.  J.  R. 
Coxe,  of  Philadelphia,  by  means  of  which  vaccination  was  first  introduced  into  that  city. 
After  the  facsimiles,  a  letter  from  Jefferson,  which  accompanied  this  supply  of  virus,  is 
inserted,  reprinted  from  Dr.  Coxe’s  volume  on  the  cow-pox. 

Washington,  December  25,  1801. 

Dear  Sir — I  am  indebted  to  you  for  several  favors  unacknowledged.  I  have  waited  ti 1 1 
1  could  inform  you  that  some  variolous  after  vaccine  inoculation  had  proved  that  I  had 
preserved  the  matter  of  the  cow-pox  in  ics  genuine  form.  Dr.  Coxe,  of  Philadelphia, 
lias  ascertained  this,  having  received  his  vaccine  matter  from  hence.  To  this  is  added 
your  information  that  the  matter  I  sent  yon  produces  the  genuine  disease,  and  conse¬ 
quently  those  in  Virginia  who  received  the  matter  from  me  are  now  in  security.  Know¬ 
ing  how  little  capable  the  people  in  general  are  of  judging  between  genuine  and  spuri¬ 
ous  matter  from  their  appearance,  or  that  of  the  sore,  I  endeavored,  in  the  course  of  my 
inoculations  at  home,  to  find  some  other  criterion  for  their  guide.  With  this  view,  I  was 
very  attentive  to  discover  whether  there  be  not  a  point  of  time  counted  from  the  vaccina¬ 
tion,  when  the  matter  is  genuine  in  all  cases.  I  thought  the  eight  times  twenty-four 
hours  furnished  such  a  point;  I  governed  myself  by  it,  and  it  has  been  followed  here 
successfully  by  Dr.  Gantt,  but  your  experience,  so  much  greater,  can  inform  us  whether 
this  rule  is  a  sure  one,  and  whether  any  other  point  of  time  would  be  still  more  certain. 
To  the  eye  of  experience  this  is  not  necessary,  but  for  popular  use  it  would  be  all-im¬ 
portant,  for  otherwise  the  disease  degenerates  as  soon  as  it  gets  into  their  hands,  and 
may  produce  a  fatal  security.  I  think  some  popular  criterion  necessary  to  crown  this  in¬ 
valuable  discovery.  Accept  assurances  of  my  great  esteem  and  respect. 

TH  JEFFERSON. 

Dr.  Benjamin  Waterhouse: 

The  ninth  and  last  of  the  series  in  which  any  reference  is  made  to  vaccination,  is  dated 
fourteen  years  after  its  nearest  predecessor.  It  is  a  long  and  admirable  letter,  and  is  in¬ 
troduced  here  because  it  contains  an  eloquent  and  consoling  tribute  to  Waterhouse  amid 
the  sad  harvest  of  vindictive,  malignant  persecution  and  ingratitude  he  was  reaping  for 
so  much  enthusiastic,  untiring,  sagacious  labor  for  the  benefifof  humanity  ;  the  only 
harvest  he  ever  gathered,  the  only  one  that  has  ever  yet  been  garnered  by  the  very 
highest  and  noblest  benefactors  of  mankind. 

How  long  the  list !  How  sad  the  thoughts  its  consideration  must  awaken  !  But,  thank 
God,  there  have  always  been  men  to  whom  the  lives  of  Galileo,  Spinoza,  Luther,  Pare, 
Vesalius,  Servetus,  Harvey,  Jenner,  Bell,  Waterhouse,  and  a  very  large  and  shining 
company  of  such  men  seem  more  attractive,  with  all  their  wrongs,  poverties,  disappoint¬ 
ments,  persecutions  and  chagrins,  than  those  of  the  sleek,  well-fed  orthodox,  conserva¬ 
tive,  successful  and  honored  mediocrities  who  always  have  been,  who  are  and  must  be, 
their  triumphant  rivals,  opponents,  persecutors.  It  is  one  of  the  best  and  surest  anchors 
and  hopes  of  humanity  that  there  always  have  been,  and  probably  always  will  be,  men 
to  whom  a  consciousness  of  the  honest  and  fearless  expression  of  important  truth,  how¬ 
ever  unpopular  or  unappreciated,  will  always  be  more  fascinating  than  the  success  and 
wealth  which  is  too  apt  to  soften  and  sweeten  the  lives  ol  the  docile  apostles  of  routiue 
and  error. 

A  brief  extract  from  a  letter  from  Waterhouse  to  his  old  friend  Lettsom  is  here  appro¬ 
priate.  It  is  dated  May  8,  1810:  “For  the  honor  of  my  country,  I  am  ashamed  to  tell 
Dr.  Jenner  how  I  have  been  treated  by  our  Legislature”  (that  of  the  State  of  Massachu¬ 
setts)  “respecting  remuneration.  I  have  received  nothing  but  abuse,  nay,  more,  I  have 
been  intrigued  out  of  my  place  as  Physician  to  the  Uuited  States  Marine  Hospital,  with 
500  sterling  a  year,  and  given  me  by  Mr.  Jefferson  as  a  reward  for  my  labors  iu  vaccina- 


Introduction  of  Vaccination  into  the  Southern  States.  189 


tion,  and  this  merely  in  consequence  of  his  going  out  and  others  coming  in,  so  that,  at 
fifty-six  years  of  age,  I  have  now  to  contrive  and  execute  some  new  plan  to  supply  this 
deficiency.  *  *  *  *  Were  I  a  single  man  and  without  children  I  would 

go  to  England  ;  if  not  to  live  there,  at  least  to  die  there.  You  do  not  knock  a  man  on 
the  head  in  Britain  because  he  exerts  himself  more  than  his  neighbors  do.  *  *  * 

Sometimes  one  man  influences  and  impels  the  sentiments  and  conduct  of  the  public.  I 
am  not  calculated  by  nature  or  habit  to  control  intrigue. ”* 

Monticello,  October  13. 

Dear  Sir — I  was  highly  gratified  with  receipt  of  your  letter  of  September  first,  by 
General  and  Mrs.  Dearborne,  and  by  the  evidence  it  furnished  me  of  your  bearing  up 
with  firmness  and  perseverance  against  the  persecutions  of  your  enemies — religious,  polit¬ 
ical  and  professional.  These  last  I  suppose  have  not  yet  forgiven  you  the  introduction 
of  vaccination  and  annihilation  of  the  great  variolous  field  of  profit  to  them;  and  none 
of  them  pai’don  the  proof  you  have  established  that  the  condition  of  man  may  be  ameli¬ 
orated,  if  not  infinitely ,  as  enthusiasm  alone  pretends,  yet  indefinitely ,  as  bigots  alone  can 
doubt.  In  lieu  of  these  enmities,  you  have  the  blessings  of  all  the  friends  of  human 
happiness  for  this  great  peril  from  which  they  are  rescued. 

I  have  read  with  pleasure  the  orations  of  Mr.  Holmes  and  Mr.  Austin.  Fromthe  former 
we  always  expect  what  is  good  ;  and  the  latter  has  by  this  specimen  taught  us  to  expect 
the  same  in  future  from  him.  Both  have  set  the  valuable  example  of  quitting  the  beaten 
grounds  of  the  Revolutionary  War  and  makiug  the  present  state  of  things  the  subject  of 
annual  animadversion  and  instruction.  A  copious  one  it  will  be,  and  highly  useful  if 
properly  improved.  Gobbet’s  address  would  of  itself  have  mortified  and  humbled  the 
Cossack  priests;  but  Brother  Jonathan  has  pointed  his  arrow  to  the  hearts  of  the  worst 
of  them.  These  reverend  leaders  of  the  Hartford  Convention  nation  it  seems  then  are 
now  falling  out  together  about  religion,  of  which  they  have  not  one  real  principle  in 
their  hearts.  Like  bawds,  religion  becomes  to  them  a  refuge  from  the  despair  of  their 
loathsome  vices.  They  seek  in  it  only  an  oblivion  of  the  disgrace  with  which  they  have 
loaded  themselves  by  their  political  ravings,  and  of  their  mortification  at  the  ridiculous 
issue  of  the  Hartford  Convention.  No  event  more  than  this  has  shown  the  placid  char¬ 
acter  of  our  Constitution ;  under  any  other  their  treason  would  have  been  punished  by 
the  halter.  We  let  them  live  as  laughing  stocks  of  the  world,  and  punish  them  by  the 
torment  of  eternal  contempt.  The  emigrations  you  mention  from  the  Eastern  States  are 
what  I  have  long  counted  on.  The  religious  and  political  tyranny  of  those  in  power 
with  you  cannot  fail  to  drive  the  oppressed  to  milder  associations  of  men  whose  free¬ 
dom  of  mind  is  allowed  in  fact  as  well  as  in  pretence.  The  subject  of  their  personal 
clawings  and  caterwaulings  is  not  without  its  interest  to  rational  men.  The  priests 
have  so  disfigured  the  simple  religion  of  Jesus  that  no  one  who  reads  the  sophistications 
they  have  engrafted  on  it,  from  the  jargon  of  Plato,  of  Aristotle,  and  other  mystics, would 
conceive  these  could  have  been  fathered  on  the  sublime  preacher  of  the  Sermon  on  the 
Mount.  Yet  knowing  the  importance  of  names,  they  have  assumed  that  of  Christians, 
while  they  are  mere  theorists,  or  anything  rather  than  disciples  of  Jesus.  Sone  of  them 
are  beginning  now  to  sling  off  these  meritorious  trappings;  their  followers  may  take 
courage  to  make  thorough  work,  and  restore  to  us  the  figure  on  its  original  simplicity  and 
beauty.  The  efforts  of  this  squabble,  therefore,  whether  religious  or  political,  cannot 
fail  to  clo  good  in  some  way. 

The  visit  to  Monticello,  of  which  you  hold  up  an  idea,  would  be  a  favor  indeed  of  the 
first  order ;  I  know,  however,  the  obstacles  of  age  and  distance,  and  should  therefore 
set  due  value  on  its  vicarious  execution.  Should  business  or  curiosity  lead  a  son  of  yours 
to  visit  this  Sodom  and  Gomorrah  of  persons,  Osgood  and  Gardener.  Accept  my  wishes 
for  yoi  r  health  and  happiness  and  the  assurance  of  my  great  esteem -and  respect 

THOMAS  JEFFERSON. 

The  following  is  the  letter  with  which  Jefferson  transmitted  that  supply  of  virus  to 
Dr.  Coxe,  of  Philadelphia,  which,  as  before  intimated,  inaugurated  vaccination  in  that 
city.  It  is  printed  from  Waterhouse’s  book  into  which  it  was  copied  from  Dr.  Coxe’s 
“  Practical  Observations  on  Vaccination,  or  inoculation  for  the  Cow-Pock,  Philadel¬ 
phia,  1802.  Page  120,  et  seq.” 

Washington,  Novembers,  1801, 

“Dear  Sir — I  received  on  the  twenty-fourth  ult.,  your  favor  of  the  twenty-second,  but 
it  is  not  till  this  day  that  I  am  enabled  to  comply  with  your  request  of  forwarding  some 
of  the  vaccine  matter  of  Dr.  Coxe.  On  my  arrival  at  Monticello  in  July,  I  received  from 
Dr.  Waterhouse,  of  Cambridge,  some  vaccine  matter  taken  by  himself,  and  some  which 
he  at  the  same  time  received  from  Dr.  Jenner,  of  London.  Both  of  them  succeeded,  and 
exhibited  precisely  the  same  aspect  and  affection.  In  the  course  of  July  and  August.  I 


'Life  and  Letters  of  John  Coakley  Lettsom,  Loudon,  1817. 


190 


Introduction  of  Vaccination  into  the  Southern  States. 


inoculated  about  seventy  or  eighty  of  my  own  family;  my  sons-in-law  about  as  many 
in  theirs,  and  including  our  neighbors  who  wished  to  avail  themselvesof  the  opportunity, 
our  whole  experiment  extended  to  about  two  hundred  persons.  One  only  case  was  at¬ 
tended  with  much  fever  and  some  delirium  ;  and  two  or  three  with  sore  arms  which  re¬ 
quired  common  dressings.  All  these  were  from  accidents  too  palpable  to  be  ascribed  to 
the  simple  disease.  About  one  in  five  or  six  had  slight  feverish  dispositions,  and  more 
perhaps  had  a  little  headache,  and  more  of  them  had  swelling  of  the  axillary  glands, 
which  in  the  case  of  adults,  disabled  them  from  labor  one,  two  or  three  days.  Two  or 
three  only  had  from  two  to  half  a  dozen  pustules  on  the  inoculated  arm,  and  nowhere 
else,  and  all  the  rest  only  the  single  pustule  where  the  matter  was  inserted,  something 
less  than  a  coffee-bean,  depressed  in  the  middle,  fuller  at  the  edge,  and  well  defined,  As 
far  as  my  observation  went,  the  most  premature  cases  presented  a  pellucid  liquor  the 
sixth  day,  which  continued  in  that  form  the  sixth,  seventh,  and  eighth  days,  when  it  be¬ 
gan  to  thicken,  appear  yellowish,  and  to  be  environed  with  inflammation.  The  most 
tardy  cases  offered  matter  on  the  eighth  day,  which  continued  limpid  the  eighth,  ninth, 
and  tenth  days.  Perceiving,  therefore,  that  the  most  premature  as  well  as  the  tardiest 
cases  embraced  the  eighth  day,  I  made  that  the  constant  day  for  taking  matter  for  inocu¬ 
lation,  say,  eight  times  twenty-four  hours  from  the  hour  of  its  previous  insertion .  In 
this  way  it  failed  to  infect  in  not  more  I  think  than  three  or  four  out  of  the  two  hundred 
cases.  I  have  great  confidence,  therefore,  that  I  preserved  the  matter  genuine,  and  in 
that  state  brought  it  to  Dr.  Gantt,  of  this  place,  on  my  return,  from  whom  I  obtained 
the  matter  I  now  send  you,  taken  yesterday,  from  a  patient  of  the  eighth  day.  He  has 
observed  this  rule  as  well  as  myself.  In  my  neighborhood  we  had  no  opportunity  of  ob¬ 
taining  variolous  matter,  to  try  by  that  test  the  genuineness  of  our  vaccine  matter;  nor 
can  any  be  had,  or  Dr.  Gantt  would  have  tried  it  on  some  of  those  on  whom  the  vaccina¬ 
tion  has  been  performed.  We  are  very  anxious  to  try  this  experiment  for  the  satisfac¬ 
tion  of  those  here,  and  also  those  in  the  neighborhood  of  Monticello,  from  whom  the  mat¬ 
ter  having  been  transferred,  the  establishment  of  its  genuineness  here  will  satisfy  them. 
I  am,  therefore,  induced  to  ask  the  favor  of  you  to  send  me  in  exchange,  some  fresh  vari¬ 
olous  matter,  so  carefully  taken  and  done  up,  as  that  we  may  rely  on  it  ;  you  are  sensible 
of  the  dangerous  security  which  a  trial  with  effete  matter  might  induce.  I  should  add 
that  we  never  changed  the  regimen  nor  occupations  of  those  inoculated  ;  a  smither  at  the 
anvil  continued  in  his  place  without  a  moment’s  intermission,  or  indisposition.  Gener¬ 
ally  it  gives  no  more  of  disease  than  a  blister  as  large  as  a  coffee-bean  produced  by  burn¬ 
ing  would  occasion.  Sucking  children  did  not  take  the  disease  from  the  inoculated 
mother.  These  I  think  are  the  most  material  of  the  observations  I  made  in  the  limited 
experiment  of  my  own  family.  In  Aikin’s  book,  which  I  have,  you  will  find  a  great  deal 
more.  I  pray  you  to  accept  assurances  of  my  esteem  and  respect. 

(Signed)  ‘  “THOS.  JEFFERSON. 

“  Mr.  John  Vaughan.” 

In  conclusion,  it  is  worthy  of  remark  how  very  completely  the  mission  of  Waterhouse 
was  accomplished.  Through  his  direct  means  vaccination  was  introduced  not  only  in 
Boston  but  in  a  very  large  proportion  of  the  other  cities  and  towns  of  America.  Those 
not  directly  supplied  with  their  first  efficient  virus  by  Waterhouse  obtained  it  through  the 
agency  of  Jefferson.  It  is  by  no  means  too  much  to  say  that  Waterhouse  and  Jefferson 
were  the  two  men  to  whom  the  introduction  of  vaccination  in  America  was  wholly  due. 
However  actively  many,  as  Goxe,  Seaman,  Scofield,  and  others  labored,  none  even  ever 
nearly  approached  these  two  in  the  success  with  which  they  propagated  perfect  vaccine  virus 
and,  directly  or  indirectly,  supplied  every  considerable  city  and  town  of  North  America, 
not  only  with  their  first  efficient  lymph  but,  over  and  over  again,  with  fresh  supplies 
when,  as  repeatedly  happened  through  ignorance,  neglect,  or,  more  frequently,  malprac¬ 
tice  (mainly  the  result  of  following  Coxe’s  teachings,  and  collecting  virus  after  the  appear 
ance,  even  after  the  decline  of  the  areola)  the  precious  contagium  was  lost.  It  is,  of  course, 
not  possible  here  to  detail  the  facts  on  which  this  broad  assertion  is  based.  Enough  that 
it  is  not  rashly  made,  but  as  the  result  and  outcome  of  careful  study  of  data  quite  suffi¬ 
ciently  full,  although  not  accessible  without  difficulty.  Let  the  assertion  stand  as  one. 
When  possibly  it  may  come  to  be  disputed  it  shall  be  pioven. 

This  remarkable  and  unique  success  was  due  to  Waterhouse,  and  from  him  Jeffer¬ 
son,  being  the  sole  recipient  of  supplies  of  virus  from  England.  To  very  mail}  others, 
societies  as  well  as  individuals,  ample  supplies  from  Jenner  and  many  of  his  earliest  En¬ 
glish  disciples  were  repeatedly  sent,  but  no  record  of  any  authenticity  has  been  discov¬ 
erable  that,  any  but  Waterhouse  and  Jefferson  succeeded  in  perpetuating  vaccina  of  a 
perfectly  normal  type  such  as  alone  could  afford  virus  fit  to  be  used  in  vaccination.  The 
simple  solution  of  this  remarkable  and  quite  exceptional  success  is  to  be  found  in  the 
fact  that  Waterhouse  was  a  true  and  faithful  disciple  of  Jenner,  that  Jefferson  was  equally 
loyal  to  the  Master  and  that  both  religiously  observed  his  “golden  rule;”  while  the  prac¬ 
tice  of  a  very  large  proportion  cf  American  physicians  was  unfortunately  influenced 
by  teachings  which  criticised  and  even  ridiculed  that  rule ;  teachings  which  have  not, 
even  yet,  fulfilled  all  their  mission  of  evil  and  injury  to  the  cause  of  vaccination  in 
America.  ” — Martin, 


Introduction  of  Yaccinnation  into  New  Yorlc. 


191 


INTRODUCTION  OF  VACCINATION  INTO  NEW  YORK,  UNITED 

STATES  OF  AMERICA. 

The  value  of  the  labor  of  Dr.  Jenner  and  Dr.  Waterhouse, were  acknow¬ 
ledge  by  the  physicians  of  New  York,  and  more  especially  by  Dr.  Val¬ 
entine  Seaman,  Edward  Miller,  Wright  Post,  Samuel  Borrowe,  Samuel 
Scofield,  Samuel  L.  Mitchell,  were  appreciated  iu  the  first  years  of  the 
nineteenth  century;  and  they  induced  a  number  of  the  prouiinent  citizens 
of  New  York,  impressed  with  the  importance  of  substituting  the  inocula¬ 
tion  of  the  vaccine  disease  for  that  of  the  small-pox,  to  form  an  association, 
and  to  contribute  to  the  establishment  of  a  public  institution,  to  extend  the 
advantage  of  vaccine  inocula  tion  to  the  poor  ; — to  main  tain  a  permanent  supply 
of  genuine  matter  for  the  use  of  that  community ,  and  to  disseminate  a  knowl¬ 
edge  of  vaccine  inoculation  among  the  physicians  of  the  adjacent  country. 

After  public  meetings,  held  by  the  contributors  for  the  purpose,  they 
formed  and  adopted  a  constitution  suited  to  their  design ;  and  then  proceded 
in  pursuance  of  the  constitution,  to  elect  the  officers  of  the  institution, 
when  the  following  gentleman  were  elected  Directors:  James  Watson, 
Samuel  Browne,  John  Reese,  Robert  Browne,  Samuel  L.  Mitchell,  Isaac 
Hicks,  Gilbert  Aspinwall,  William  Moore,  Thomas  Buckley,  Samuel  Miller, 
Willet  Seaman,  Andrew  Cock,  James  Robertson;  Thomas  Franklin,  Treas¬ 
urer;  Adrian  liegeman,  Secretary. 

The  directors  made  choice  of  the  following  gentlemen  to  perform  the 
various  duties  assigned  to  their  office  by  the  constitution :  James  Watson, 
President;  Gilbert  Aspinwall,  Vice  President. 

Medical  Board. — Valentine  Seaman,  Edward  Miller,  Wright  Post,  Samuel 
Browne;  Samuel  Scofield,  Resident  Surgeon  - 

A  suitable  apartment  was  obtained  and  the  Medical  Board  commenced 
vaccine  inoculation. 

At  a  meeting  of  the  contributors  the  following  resolution,  moved  by 
Mr.  Samuel  Browne,  was  unanimously  adopted,  viz: 

u  Resolved,  That  in  testimony  of  the  high  estimation  in  which  this  meet¬ 
ing  of  contributors  hold  the  philanthropic  and  able  exertions  of  Edward  Jen- 
ner,  M.  D.,  F.  R.  S.,  etc.,  of  London,  and  Benjamin  Waterhouse,  M.  D., 
professor  of  practice  in  the  University  of  Crambridge,  iu  Massachusetts, 
relative  to  the  inoculation  of  the  Kine-Pock,  tfiey  are  hereby  appointed 
perpetual  honorary  directors  of  this  Institution.’7 — Medical  Repository ,  vol.  5, 
New  York ,  1802,  p.  346-7. 

The  Medical  Profession  of  the  United  States  were  deeply  indebted  to  the 
learned  and  eloquent  editors  of  the  Medical  Repository,  for  the  first  full 
and  scientific  reviews  of  the  discoveries  of  Jenner,  and  the  works  of  Pear¬ 
son,  Woodville  and  others. 

Drs.  Samuel  Latham,  Mitchell,  Edward  Miller,  and  Elihu  H.  Smith,  pub¬ 
lished  au  account  of  Dr.  Jeuner’s  “  Inquiry  into  the  causes  and  effects  of 
the  variolse  vaccinse,”  in  the  second  volume  of  the  Medical  Repository,  p. 
244,  third  edition. 

Letters  from  Dr.  Pearson,  as  well  as  accounts  of  his  work  and  that  of 
Dr.  Woodville,  were  published  iu  the  Medical  Repository,  volume  third, 
pp.  70,  315,  etc. 

In  the  same  (third)  volume  of  the  Medical  Repository,  p.  310,  it  is  stated 
that  Dr.  George  Pearson,  of  London,  had  transmitted  in  a  letter  to  Dr. 
Edward  Miller  a  thread  impregnated  with  the  matter  of  the  vaccine  dis¬ 
ease,  for  the  purpose  of  inoculation  in  North  America,  with  a  view  to  its 
use  as  a  substitute  for  the  small-pox. 


192 


Introduction  of  Vaccination  into  New  York. 


The  readers  of  this  valuable  medical  journal  are  informed  as  to  the 
progress  of  vaccine  inoculation  in  Europe  and  America.  (See  vol.  4,  pp.  88, 
176,  204,  321,  322,  vol.  5,  vol.  4,  pp.  410,  p.  205,  etc.) 

The  vaccine  matter  received  in  New  York  during  1800,  did  not  succeed 
according  to  the  expectations  of  Dr.  Edward  Miller,  and  lie  expressed  the 
opinion  that  the  matter  employed  was  not  genuine.  ( Medical  Repository, 
vol  4|>.  321.) 

For  the  introduction  of  vaccination  into  New  York,  the  people  were  in¬ 
debted  to  the  persevering  and  philanthropic  exertions  of  Doctor  Valentine 
Seaman,  who,  on  the  twenty-second  of  May,  1801,  procured  virus  from  the 
arm  of  Governor  Sargent’s  domestic,  who  was  vaccinated  in  Boston  by 
Doctor  Benjamin  Waterhouse,  and  fortunately  arrived  in  New  York,  at  the 
proper  period  for  procuring  the  virus.  With  this  infection  Dr.  Seaman  in¬ 
oculated  several,  and  succeeding  in  communicating  the  genuine  variolae 
vaccinse’ 

There  had  been  virus  received  in  New  York,  during  the  preceding 
winter,  but  unfortunately  it  gave  rise  to  a  spurious  disease. 

In  January,  1802,  an  institution  was  established  in  New  York  for  the 
purpose  of  vaccinating  the  poor  gratis,  and  of  keeping  up  a  constant  sup¬ 
ply  of  the  genuine  matter.  In  this  establishment  Samuel  Scofield,*  M.  D. 
was  appointed  resident  surgeon.  This  institution  was  subsequently  con¬ 
nected  with  the  New  York  City  Dispensary,  and  a  physician  appointed  for 
the  express  purpose  of  vaccinating  such  as  applied  for  that  purpose. 

Dr.  V.  Seaman,  Physician  of  the  Kine-Pock  Dispensary,  reported  to  the 
trustees  on  the  third  of  January,  1807 :  “That  the  practice  of  vaccination 
has  been  regularly  attended  to,  and  that  by  means  of  this  establishment, 
nearly  eleven  hundred  have  been  inoculated;  not  one  of  whom  has  been 
known  since  to  have  taken  the  small-pox. 

“During  the  fifteen  years  immediately  preceding  the  introduction  of  the 
vaccine  disease  into  this  city,  it  appears,  by  a  regular  record  preserved  by 
the  sextons,  5,756  persons  were  interred  in  the  cemeteries  of  St.  Paul’s  and 
Trinity,  of  which  610,  which  is  upwards  of  the  tenth  part  of  the  whole 
number,  had  died  under  the  immediate  operation  of  the  small-pox.  From 
the  public  obituary,  since  established  by  the  corporation,  we  find  that 
in  the  years  1805  and  1806,  4,595  persons  have  died  in  this  city ;  110  only, 
which  is  less  than  one-fortieth  part,  was  by  the  small-pox  ;  where  it  may 
be  fairly  inferred,  that  during  the  last  two  years,  the  practice  of  vaccina¬ 
tion  has  preserved  276  of  our  fellow  citizens  from  falling  victims  to  that 
most  loathsome  of  all  human  maladies,  while  it  does  not  form  a  single 
item  on  the  bills  of  mortality.  If  individuals  would  attend  reasonably  to 
partake  of  the  means  now  offered  for  their  protection,  it  is  more  than 
probable,  that  in  a  little  time  the  small  pox  would  only  be  heard  of  in  his- 
iory,  and  our  country  be  freed  from  one  of  the  most  dreadful  scourges.” — 
The  Medical  Repository ,  vol.  4,  New  York,  1807,  p.  430. 

In  order  to  determine  the  value  of  vaccination  in  New  York,  which  from 
its  geographical  position,  its  extended  commercial  connections,  and  the 
vast  multitudes  of  foreign  emigrants  passing  through  this  great  gate- way 
of  the  North  American  Continent,  was  tlm  most  exposed  of  all  cities  to  the 
ravages  of  this  pestilence,  I  consolidated  from  the  official  reports  of  this 
city  the  mortality  during  the  period  of  half  a  century,  immediately  follow¬ 
ing  the  introduction  of  vaccination. 


*“A  Practical  Treatise  on  Vaccine  or  Cowpock’  by  Samuel  Scofield,  M.  D.,  one  of  the  physicians  of  the 
New  York  City  Dispensary,  and  first  Kesident  Surgeon  of  the  New  York  Institution  for  the  Inoculation  of 
he  Cowpock.”  Embellished  with  a  colored  engraving  repiesenting  a  view  of  the  local  affection  in  its  differ 
nt  stages.  New  York ;  Printed  by  Southerick  &  Pelsue,  for  Collins  &  Perkins,  1810. 


Introduction  of  Vaccination  into  New  YorTc. 


193 


Total  Deaths  from  all  Causes,  and  from  Small- Pox,  Measles,  Scarlet  Fever  and  Phthisis- 
Pulmonalis  in  the  City  of  New  York  during  a  Period  of  Fifty  Years,  1891-L853, 


# 

TEAK. 

Total  Deaths 

FHOM 

Alt.  Causes. 

DEATHS  FROM 

Small-Pox. 

Measles. 

Scarlet 

Eerer. 

Phthisis 

Pulmonalis. 

1804 . 

2125 

164 

2 

14 

499 

1805 .  . 

2344 

62 

0 

4 

462 

1806  . 

2225 

48 

0 

4 

354 

1807  . 

2312 

29 

1 

2 

464 

1808  . 

2014 

62 

64 

4 

429 

1800  . 

2108 

66 

2 

9 

413 

1810 .  . 

2167 

4 

2 

1 

562 

1811 . 

2524 

117 

2 

0 

595 

1812 . 

2553 

21 

9 

0 

669 

1813 . 

2283 

2 

35 

1 

562 

1814 . . 

1974 

2 

15 

1 

572 

1815 . . . 

2507 

94 

18 

0 

618 

1816 . 

2739 

179 

19 

0 

678 

1817 . . 

2527 

14 

20 

3 

574 

1818 . 

3265 

19 

18 

0 

591 

1819  . 

3176 

0 

10 

5 

577 

1820  . 

3515 

0 

74 

5 

625 

1821 . 

3542 

0 

109 

3 

715 

1822  . • . 

3231 

0 

1 

1 

624 

1823  . 

3444 

18 

117 

2 

683 

1824  ....  . 

4341 

394 

100 

3 

730 

1825  . . 

5018 

40 

53 

10 

843 

1826.. . 

4973 

58 

31 

24 

820 

1827  . . 

5181 

149 

172 

4 

829 

1828  . 

5181 

93 

28 

11 

906 

1829  . . 

5094 

16 

91 

188 

880 

1830  . 

5537 

176 

12 

246 

974 

1831 . 

6363 

224 

39 

258 

1033 

1832  . . 

10389 

89 

290 

221 

1514 

1833  .  . 

5746 

25 

38 

179 

1251 

1834  . . 

9082 

233 

212 

418 

1471 

1835  . 

7082 

351 

82 

174 

1437 

1836  . . 

8009 

173 

442 

202 

1514 

1837  . . 

3732 

164 

288 

579 

1458 

1838  .  . 

5053 

91 

79 

257 

1225 

1839  . 

7953 

68 

133 

158 

1318 

1840  . 

8474 

332 

185 

391 

1296 

1841 . . 

9115 

200 

113 

360 

1470 

1842  . 

9176 

181 

60 

416 

1339 

1843  . . 

8693 

117 

118 

223 

1503 

1844  .  . 

8875 

21 

5L 

224 

1428 

1845  . 

10483 

125 

136 

63 

1659 

1846 . . 

11318 

141 

17 

114 

1690 

1847  . 

15788 

53 

275 

142 

1626 

1848  . . 

15919 

544 

77 

93 

1869 

1849  . 

23773 

326 

125 

266 

2086 

1850  . 

16978 

231 

324 

311 

1922 

1851 . 

21924 

562 

320 

627 

2374 

1852  . 

21601 

407 

246 

613 

2487 

1853  . 

22702 

656 

134 

454 

2739 

Total . 

364698 

7131 

4749 

8398 

55265 

From  the  preceding  statistics  we  gather  that  out  of  a  total  of  304,698 
deaths  from  all  causes  (males,  193.432;  females,  106,266;  excess  of  males 
32,166  or  19.35  per  cent),  occurring  in  New  York  during  50  years,  1804- 
1853  inclusive,  small-pox  occasioned  only  7131  deaths. 

During  the  same  period  measles  occasioned  4149 .deaths  and  scarlet  fever 
8398;  these  two  diseases  occasioned  13,147  deaths,  or  nearly  twice  the 
number  caused  by  the  more  fatal  pestilence  small-pox. 

Phthisis  pulmonalis  caused  55,205  deaths  or  about  eight  times  the  num¬ 
ber  credited  to  small  pox. 

We  must  attribute  this  result,  that  is  the  comparatively  small  mortality 
from  small  pox  to  vaccination  Some  estimate  of  the  number  of  emigrants 
pouring  in  from  Europe  may  be  formed  from  the  fact  that  from  May  5,  1847? 
to  the  end  of  1853,  there  arrived  at  New  York,  1,627,174  white  emigrants. 


194 


Introduction  of  Vaccination  into  Philadelphia. 


INTRODUCTION  OF  VACCINATION  INTO  PHILADELPHIA, PENN¬ 
SYLVANIA. 

In  Philadelphia,  Dr.  John  Redman  Coxe  made  most  laudable  efforts  to 
introduce  the  inoculation  of  the  cow-pox  into  Philadelphia,  Penn.,  and  in 
1802,  lie  published  his  u Practical  Observations  on  Vaccination  or  Inoculation 
for  the  cow-pochV  in  which  he  duly  appreciated  the  value  of  the  discovery 
of  Edward  Jenuer,  and  endeavored  with  a  zealous  and  benevolent  warmth, 
to  recomemnd  this  safe  and  easy  substitute  for  the  small  pox. 

Most  of  the  leading  facts  and  principles  concerning  the  cow-pock,  known 
and  ascertained  at  the  time,  are  noticed  in  this  publication. 

Much  discussion  and  difference  of  opinion  having  arisen  on  the  question 
how  late  in  the  disease  it  may  be  allowed  to  take  matter  for  the  purpose  of 
inoculation,  Dr.  Coxe  could  not  entirely  agree  with  Dr.  Edward  Jenuer, 
who  enjoined  it  upon  inoculators  to  consider  the  appearance  of  the  efflores¬ 
cence,  as  a  sacred  boundary  which  might  not  be  trangressed.  Dr.  Coxe 
was  inclined  to  believe,  that  while  the  fluid  in  the  vesicle  continues  limpid, 
and  the  scab  is  not  too  far  advanced ,  no  inconvenience  will  arise  from  the  use 
of  the  matter;  and  the  point  of  time  beyond  which  the  matter  is  not  ordin¬ 
arily  to  betaken  he  supposes  may  properly  be  eight  times  twenty-four  hours. 

Dr.  Coxe  records  his  belief  in  the  efficacy  of  vaccination  in  correcting 
the  scrofulous  diathesis,  in  removing  certain  cutaneous  diseases,  and  curing 
whooping-cough  and  deafness. 

Dr.  John  Redman  Coxe  published  farther  observations  on  vaccination  in 
1804.  (See  the  Medical  Repositorv,  Second  Hixade,  vol.  1;  New  York, 
1804;  pi  122.) 

Mr.  Bryce,  of  Edinburgh,  in  his  Observatioyis  on  the  Cow-pox,  published 
in  1802,  advocated  the  use  of  the  crust  of  the  vesicle  after  it  falls  from  the 
arm  ;  and  also  proposed  a  mode  of  ascertaining  whether  the  constitution  had 
been  affected  by  the  vaccine  virus,  by  a  double  inoculation,  the  second  be¬ 
ing  performed  some  days  after  the  first. 

Wm.  Farquliarson,  James  Bryce,  A.  Gillespie  and  J.  Abercrombie,  of 
the  Vaccine  Institution  of  Edinburgh,  after  recording  7140  vaccinations 
from  February,  1801,  to  February,  1807,  state  that  “  by  using  the  crust, 
the  cow-pox  has  frequently  been  renewed  at  this  institution,  when  the  fluid 
virus  had  been  lost,  from  the  non-attendance  of  the  children  at  the  proper 
period  of  taking  it.” 

From  a  report  of  Mr.  Shoolbred,  of  Calcutta,  it  is  shown  that  u  by  this 
mode  of  using  the  crust,  the  cow-pox  had  been  renewed  at  the  different 
out-stations  in  the  Province  of  Bengal,  at  Prince  of  Wales  Island,  and  at 
Port  Marlborough,  when  the  virus  had  been  lost,  and  every  means  of 
transmitting  it  from  Calcutta  had  proved  ineffectual.” — Edinburgh  Medical 
and  Surgical  Journal ,  1807/  vol.  3,  p.  253. 

The  following  tables,  consolidated  from  official  sources,  will  present  in  a 
clear  light  the  relations  of  small-pox  to  other  diseases  in  Philadelphia; 
and  will  also  clearly  demonstrate  the  protective  power  of  vaccination. 
These  figures  are  of  special  value  and  force,  when  compared  with  those  of 
London,  England,  previously  recorded,  illustrating  the  mortality  occa¬ 
sioned  by  small  pox  in  that  city  during  the  seventeenth  and  eighteenth 
centuries,  before  the  introduction  of  vaccination,  when  the  population  ap¬ 
proximated  to  that  of  Philadelphia,  during  the  period  under  observation  : 


Small-Pox  and  Vaccination  in  Philadelphia. 


195 


Deaths  in  Philadelphia,  Penn.,  from  Small-Pox,  each  year,  from  1807  to  1882,  inclusive,  with 


the  Average  Population  of  each  year  and  Deaths  to  every  1000  Persons  Living. 


Tears. 

Population . 

Deaths  from 
Small-Pox. 

Deaths  from 
Small-P  o  x 
in  1000  Liv¬ 
ing  Persons 

Years, 

Population. 

Deaths  from 
Small-Pox. 

Deaths  from 
Small-P  o  x 
in  1000  Liv¬ 
ing  Persons 

1807  . 

32 

0.27 

1845  .... 

190 

0.73 

1808  . 

f 

145 

1  28 

1846 . 

251 

0.61 

1809 . 

* 

101 

0.90 

1847 . 

f 

9 

0.02 

1810 . 

< 

111.210 

34 

0.30 

1848. . 

100 

0.24 

1811 . 

117 

1.04 

1849  . 

408,762 

152 

0.37 

1812 . 

1850 

40 

0.09 

1813 . 

1851 . 

t 

216 

0.52 

1814 . 

1852  . 

427 

1.04 

1815  . 

1853 . 

57 

0.13 

1816 . 

97 

0.77 

1854 . 

40 

0.09 

1817 . 

52 

0.30 

1855 . 

275 

0.67 

1818 . 

8 

0  05 

1356 . 

390 

0.68 

1819 . 

r 

1 

1857 . 

0.11 

1820 . 

1858 . 

1 

7 

0.01 

1821 . 

< 

137,097 

1859 . 

2 

0  003 

1822  . 

1860 . 

1 

565,529 

57 

0.10 

1823 . 

160 

1.16 

1861  . 

758 

1.34 

1824  . 

325 

2.37 

1802  . 

| 

264 

0.46 

1825  ...  . 

6 

0  04 

1863 . 

171 

0.30 

1826 . 

3 

0  01 

1864  . 

260 

0.45 

1827  . 

r 

100 

0.52 

1565 . 

524 

0.92 

1828  . 

107 

0.56 

1806 . 

144 

0.21 

1829 . 

J 

188,797 

81 

0  42 

1867  _ 

48 

0.07 

1830 . 

. 

86 

0  45 

1868  . 

r 

48 

0  07 

1831 . 

14 

0.07 

1869  . 

6 

0.008 

1832  . 

37 

0.19 

1870 . 

1 

674,622 

9 

0.01 

1833  . 

150 

0.82 

1871  . 

1,879 

2  78 

1834 _ _  ... 

195 

1.03 

1872... . 

2,585 

3.83 

1835  . 

101 

0.53 

1873  . 

39 

0.05 

1836 . 

76 

0.33 

1874 . 

15 

0.02 

1837 

*  79 

0  34 

1875 . 

54 

0  08 

1838 

r 

42 

0.16 

1876 . 

407 

0.45 

1839 . 

j 

5 

0.01 

1877  . 

( 

155 

0.17 

1R40 

J  OPQ  034 

63 

O  24 

1 R78 

1 

1841 . 

259 

1.00 

1879  _ 

< 

846,980 

6 

0.006 

1842  . 

156 

0.60 

1880.  . . 

429 

0.05 

1843 

36 

0.13 

1881  . 

1,336 

1.57 

1844...  . 

17 

0.06 

1882 . 

314 

0.03 

Total  deaths  from  Small-pox  for  76  years  .  13,813 


From  tlie  preceding  table  it  is  established  that  during  the  past  seventy 
six  years  small-pox  has  occasioned  deaths  in  Philadelphia  in  sixty-eight 
years,  and  that  in  only  eight,  years  was  the  disease  entirely  absent ;  and 
that,  notwithstanding  its  almost  constant  presence,  it  occasioned  only  13,- 
812  deaths  during  the  entire  series  of  years  embraced  in  the  table.  Dur¬ 
ing  the'  first  thirty-nine  years,  1807-1845  inclusive,  small-pox  occasioned 
2281  deaths,  and  in  the  last  thirty-seven  years,  1846-1882  inclusive,  11,532 
deaths;  total  seventy-six  years,  13,813. 

The  apparent  increase  of  deaths  during  the  last  seven  years  from  small¬ 
pox  must  be  referred  chiefly  to  the  increase  of  population  ;  during  the  first 
thirty-nine  years  (1807-1845)  the  population  of  Philadelphia  ranged  from 
111,210  to  268,034.  and  during  the  last  thirty-seven  years  (1846-1882)  from 
408,762  to  846,980. 

That  small-pox  has  played  but  a  secondary  part  in  the  mortality  of  Phil¬ 
adelphia,  will  be  evident  from  a  comparison  with  the  following  statistics:* 


*Healtlx  Officer’s  Annual  Report,  City  of  Philadelphia,  1882.  Philadelphia,  1883;  p.  201,  p.  2, 


196 


Small-Pox  and  Vaccination  in  Philadelphia. 


Table  showing  the  ratio  of  deaths,  with  population  in  Philadelphia,  Pennsylvania,  during  the 

past  twenty-two  years. 


YEARS. 

Population. 

Deaths  from 
all  causes. 

Deaths  to  1000 
persons. 

Persons  living 
to  one  death. 

576,408 

13,540 

23.49 

42.57 

587,287 

13,864 

23.60 

42  36 

1863  . 

598.166 

14,220 

23.73 

42.06 

608,045 

15,875 

26.10 

38.30 

1865  . 

618,924 

15.633 

25.25 

39.59 

620,803 

15,362 

22.80 

40.99 

1867  . 

640,682 

12,660 

19.76 

50 . 60 

1868  . 

651,561 

13,391 

20.39 

48.65 

662,440 

13,428 

20.27 

49.33 

t674.022 

15,317 

22.72 

44.00 

700,000 

15,485 

22.12 

45.20 

1872  . . . . 

725,000 

15.238 

26.19 

38.18 

750,000 

15,224 

20.29 

49.26 

1874  . 

775,000 

15,987 

19.66 

50.86 

1875 . . 

800,000 

17.805 

22.25 

44.93 

825,594 

18,892 

22.88 

43  69 

850,856 

16,004 

18.81 

53.16 

1878  . . 

876,118 

15.743 

17.97 

55.65 

901,380 

15.473 

17.17 

58.25 

1880  . 

1846.980 

17.711 

20.91 

47.82 

1881 . 

868.000 

19  515 

22.48 

44.47 

1882 

886,539 

20,059 

22.62 

44.19 

Note — tUnited  States  census,  the  intervening  years,  population  estimated. 


Total  Deaths  from  Diphtheria  and  Scarlet  Fever  in  Philadelphia,  Pennsylvania,  during  the 

past  Fifteen  Years — 1868-1882. 


YEARS. 

Total  Deaths 
Diphtheria. 

Total  Deaths 
Scarlet  Eever 

YEARS. 

Total  Deaths 
Diphtheria. 

Total  Deaths 
Scarlet  Fever. 

1868 . 

119 

224 

i876  . 

708 

328 

1869 . 

182 

799 

Is77 . . 

458 

379 

letTO  . 

172 

953 

1 878 . 

464 

554 

1871 . 

145 

262 

1879  . 

321 

336 

1872  . 

150 

174 

1880. . . 

323 

291 

1873  . . 

no 

319 

1881  .... 

457 

486 

1874  . 

170 

461 

1882 . 

933 

310 

1875  . 

652 

1,032 

*Health  Officer’s  Annual  Report,  1882,  p.  4. 


Total  Deaths  from  Consumption,  Typhoid  Fever,  Scarlet  Fever  and  Small-pox  in  Philadelphia, 
Pennsylvania,  during  Twenty-one  Years — 1862-1882. 


DEATHS  FROM 

DEATHS  FROM 

P5 

El 

t*' 

Consump¬ 

tion. 

Typhoid 

fever. 

Scarlet 
fever . 

Small-Pox. 

YEAR. 

Consump¬ 

tion. 

Typhoid 
Fever . 

Scarlet 

Fever. 

Small -Pox. 

1862. 

1949 

654 

461 

264 

1873.. 

2291 

364 

319 

39 

1863. 

1953 

486 

275 

171 

1874.. 

2304 

491 

461 

15 

1864. 

2089 

648 

349 

260 

1875. 

2359 

419 

1032 

54 

1865. 

202G 

773 

624 

524 

1876.. 

2776 

761 

328 

407 

1866. 

1944 

381 

491 

144 

1877.. 

2349 

542 

379 

155 

1867. 

1947 

367 

367 

48 

1878.. 

2491 

404 

554 

1868. 

1995 

395 

224 

48 

1879.. 

2481 

•  344 

336 

6 

1869 

1975 

373 

799 

6 

I860.. 

2692 

498 

291 

429 

1870. 

2303 

409 

953 

9 

1881 

2768 

645 

486 

1336 

1871  . 

1872. 

2337 

2330 

313 

369 

262 

174 

1879 

2585 

1882. . 

1 

2S09 

650 

310 

314 

The  deaths  from  typhoid  fever  alone  numbered,  in  twenty-one  years, 
10,25a 


Small-Pox  and  Vaccination  in  South  Carolina. 


197 


The  remarkable  exemption  of  the  citizens  of  Philadelphia,  from  the  ra¬ 
vages  of  small-pox  during  the  nineteenth  century,  may  be  justly  attributed 
to  the  faithful  advocacy  and  efficient  practice  of  vaccination,  by  her  learn¬ 
ed  and  philanthropic  physicians. 


SMALL-POX,  AND  THE  INTRODUCTION  OP  VACCIXATIOX 

INTO  SOUTH  CAROLINA. 

Small-pox  committed  fearful  ravages  amongst  the  North  American  In¬ 
dians  who  were  protected  neither  by  inoculation  nor  subsequently  by  vac¬ 
cination.  Entire  nations  and  tribes  disappeared — swept  away  by  small¬ 
pox,  without  leaving  any  record  of  their  sufferings.  This  fearful  scourge 
first  introduced  into  Mexico  by  the  Spaniards  in  1520,  and  at  various  sub¬ 
sequent  periods  by  the  French  and  English  colonists,  has  been  the  chief 
agent  in  the  destruction  of  the  aboriginal  inhabitants  of  North  America. 

The  powerful  nation  of  the  Katahbas,  which,  in  the  early  history  of 
South  Carolina,  numbered  several  thousand  warriors,  in  1743  could  muster 
scarcely  400  men.  In  1738,  small  pox  destroyed  one  half  of  the  Cherokee 
nation  ;  and  the  Muskohgees,  Uchees,  Shawnese,  Choctaws,  Chickasaws, 
Natchez,  and  many  other  tribes  ha  ve  suffered  to  an  equal  extent. 

In  describing  the  Sewees  of  South  Carolina,  John  Lawson  says  :  “These 
Sewees  have  been  formerly  a  large  nation,  though  now  very  much  de¬ 
creased,  since  the  English  hath  seated  on  their  land,  and  all  other  nations 
of  Indians  are  observed  to  partake  of  the  same  fate  where  the  Europeans 
come,  the  Indians  being  a  people  very  apt  to  catch  any  distemper  they  are 
afflicted  withal;  the  small  pox  has  destroyed  many  thousands  of  these 
nations,  who,  no  sooner  than  they  are  attacked  with  the  violent  fevers  and 
the  burning  which  attends  that  distemper,  fling  themselves  overhead  in  the 
water  in  the  very  extremity  of  the  disease  ;  which,  shutting  the  pores,  hin¬ 
ders  a  kindly  evacuation  of  the  pestilential  matter  and  drives  it  back,  by 
which  means  death  most  commonly  ensues — not  but  in  other  distempers, 
which  are  epidemical,  you  may  find  among  them  practitioners  that  have 
extraordinary  skill  and  success  in  removing  those  morbific  qualities  which 
afflict  them.” 

John  Lawson  visited  Carolina  in  1700.  A  New  Voyage  to  Carolina, 
containing  the  exact  description  of  that  country ,  together  with  the  present  state 
thereof ,  and  a  Journal  of  a  Thousand  Miles ,  traveled  through  several  Nations 
of  Indians ,  giving  a  particular  account  of  their  customs ,  manners,  etc.  By 
John  Lawson,  Gent ,  Surveyor  General  of  North  Carolina.  London  :  Printed 
in  the  year  1709  ;  p.  10,  p.  224. 

In  another  portion  of  his  “  New  Voyage  to  Carolina,’’  John  Lawson  says 
with  reference  to  the  Indians  of  North  Carolina: 

“  The  small  pox  has  been  fatal  to  them  ;  they  do  not  often  escape  when 
they  are  seized  with  that  distemper,  which  is  a  contrary  fever  to  which 
they  ever  knew.  Most  certain,  it  had  never  visited  America  before  the 
discovery  thereof  by  the  Christians.  Their  running  into  the  water,  in  the 
extremity  of  this  disease,  strikes  it  in  and  kills  all  that  use  it.  Now  they 
are  becoming  a.  little  wiser,  but ’formerly  it  destroyed  whole  towns  without 
leaving  one  Indian  alive  in  the  village.”  p.  223-224. 

“A  letter  from  the  Governor  and  Lord’s  Proprietors,  dated  March  12, 
1697-8,  states: 

“  We  have  had  the  small-pox  amongst  us  nine  or  ten  months,  which  hath 
been  very  infectious  and  mortal ;  we  have,  lost  by  the  distemper  200  or  300 
persons.  And  on  the  twenty -fourth  of  February  last,  a  fire  broke  out  in  the 
night  in  Charlestown,  which  hath  burnt  the  dwellings,  stores  and  out-houses 


198 


Small-Pox  and  Vaccination  in  South  Carolina. 


of  at  least  fifty  families,  and  hath  consumed  (it  is  generally  believed )  in  houses 
and  goods  the  value  of  £80,000  sterling.”  In  a  subsequent  letter,  dated 
April  28,  1698,  they  state  that  the  small-pox  still  continued,  but  was  not 
so  fatal  as  in  the  cold  weather,  and  that  a  great  number  of  Indians  had  fell 
victims  to  the  disease.* 

Dr.  David  Bamsay  is  evidently  in  error  when  he  states  that  the  years 
1700  and  1717  were  the  dates  of  the  two  first  attacks  of  small-pox  in 
Charleston;  it  is  evident  from  the  preceding  facts  that  the  small-pox  pre¬ 
vailed  in  1697  and  1698. 

Dr.  Bamsay  also  appears  to  be  in  doubt  about  the  dateof  the  first  appear¬ 
ance  of  yellow-fever  in  Charleston,  for,  in  his  Medical  History  of  South 
Carolina  from  1670  to  1808,  he  says  that  “  in  the  year  1699  or  1700,  in  addi¬ 
tion  to  the  calamities  resulting  from  a  desolating  fire  and  a  fatal  epidemic 
small-pox,  a  distemper  broke  out  in  Charleston  which  carried  off  an  incred¬ 
ible  number  of  people,  among  whom  were  Chief  Justice  Bohun,  Samuell 
Marshall,  the  Episcopal  clergyman ;  John  Eiy,  the  Beceiver  General ;  Edward 
Bawlins,  the  Provost  Marshal;  and  almost  one-half  of  the  members  of  the 
Assembly.  Never  had  the  colony  been  visited  with  such  general  distress  and 
mortality.  Some  whole  families  were  carried  off,  and  few  escaped  a  share 
of  tlic  public  calamities.  Almost  all  were  lamenting  the  loss  either  of  their 
habitations  by  the  devouring  flames,  or  their  friends  and  relatives  by  this 
disease,  or  the  small  pox.  Anxiety  and  distress  were  visible  on  every 
countenance.  Many  of  the  survivors  seriously  thought  of  abandoning  a 
country  on  which  the  judgment  of  heaven  seemed  to  fall  so  heavy.  Dr. 
Hewatt,  from  whom  the  preceding  account  is  taken,  designates  this  malady 
by  the  general  appellation  of  ‘an  infectious  distemper.’  It  was  generally 
called  the  plague  by  the  inhabitants.  From  tradition  and  other  circum¬ 
stances,  particularly  from  the  contemporaneous  existence  of  yellow-fever  in 
Philadelphia,  there  is  reason  to  believe  that  this  malady  was  the  yellow- 
fever;  and,  if  so,  was  the  first  appearance  of  that  disorder  in  Charles¬ 
town,  and  took  place  in  the  nineteenth  or  twentieth  year  after  it  began  to 
be  built. t” 

Dr.  Frederick  Dalcho  has  definitely  fixed  the  date  of  this  outbreak  of 
yellow  fever  in  Charlestown  in  the  year  1699.  Thus  this  historian  says: 

u  The  Eev.  Mr.  Marshall  died  in  1699,  of  a  malignant  disease  which  swept 
off  many  of  the  principal  inhabitants  of  Charlestown.  This  disease  was 
probably  the  yellow  fever  which  raged  at  the  same  time  in  Philadelphia. 
In  a  letter  from  the  Governor  and  Council  to  the  Lord’s  Proprietors,  dated 
Charlestown,  in  South  Carolina,  January  17,  1699-1700,  they  state  that 
they  had  nothing  to  communicate,  but  that  a  most  infectious,  pestilential 
and  mortal  distemper  (the  same  which  hath  always  been  in  one  or  more  of 
His  Majesty’s  American  plantations  for  eight  or  nine  years  last  past), 
which  from  Barbadoes  or  Providence  was  brought  in  among  us  into 
Charlestown  about  the  twenty-eighth  or  twenty-ninth  of  August  last  past, 
and  the  decay  of  trade  and  the  mutations  of  your  Lordship’s  public  officers 
occasioned  thereby.  This  distemper,  from  the  time  of  its  beginning  afore¬ 
said  to  the  first  day  of  November,  killed  in-  Charlestown  at  least  160  per¬ 
sons,  among  whom  were  Mr.  Ely,  Beceiver  General ;  Mr.  Amory,  Beceiver 
for  the  Public  Treasury;  Edward  Bawlins,  Marshal;  Edmund  Bohun, 
Chief  Justice.  Amongst  a  great  many  other  good  and  capital  merchants 


*Au  Historical  Account  of  the  Protestant  Episcopal  Church  in  South  Carolina  from  the  first  settlement 
of  the  Province  to  the  War  of  the  Revolution,  etc. ;  by  Frederick  Dalcho,  M.  D.,  Assistant  Minister  of  St. 
Michael's  Church  ;  Charleston,  p.  32. 

tThe  History  ot  South  Carolina,  from  its  first  settlement  in  1070  to  the  year  1808,  in  two  volumes;  by  Da¬ 
vid  Ramsay,  M.  D. ;  Charleston,  1800 ;  vol.  2,  p.  82. 


199 


Small-Pox  and  Vaccination  in  South  Carolina. 


and  housekeepers  in  Charlestown  the  Bev.  Mr.  Marshall,  our  minister,  was 
taken  away  by  the  said  distemper.  Besides  those  that  have  died  of  this 
distemper  in  Charlestown,  ten  or  eleven  have  died  in  the  country,  all  which 
got  the  distemper  and  were  infected  m  Charlestown,  went  home  to  their 
families  and  died  5  and  what  is  notable,  notone  of  all  their  families  was 
infected  by  them.  This  afflictive  dispensation  of  Providence  is  likewise 
mentioned  in  a  letter  from  Isaac  Norris,  dated  November  18,  1099,  O.  S. 
It  states  that  4 150  persons  had  died  in  Charlestown  in  a  few  days;  that 
the  survivors  fled  into  the  country,  and  that  the  town  was  thinned  to  a 
very  few  people!* * * § 

Small-pox  appeared  again  in  1717,  and  returned  in  1732,  but  in  this  latter 
year  effectual  care  was  taken  to  prevent  its  spreading. 

In  the  year  1738,  small-pox  was  imported  in  a  Guinea  Ship,  and  spread 
so  extensively  that  there  was  not  a  sufficency  of  persons  in  health  to  attend 
the  sick ;  and  many  persons  perished  from  neglect  and  want.  There  was 
scarcely  an  hour  in  which  there  had  not  been  one  or  more  deaths. 

From  a  manuscript  in  the  hand-writing  and  found  among  the  papers  of 
the  venerable  Thomas  Lamboll,  who  died  in  1775,  the  following  particulars 
are  collected  relative  to  this  disease. 

“It  first  attracted  public  notice  in  May,  1738.  In  the  next  month  a  fast 
day  was  appointed  by  proclamation.  Soon  after  the  disease  commenced,  a 
report  was  circulated  that  tar  water  was  not  only  a  good  preparation  for 
recovering,  but  a  preventive  of  the  small  pox.  Many  barrels  of  tar  were 
sold  and  used  for  that  purpose;  but  the  author  soou  after  took  the  infection 
and  died,  and  his  empirism  died  with  him. 

“By  an  account  dated  September  30,  of  the  same  year,  it  appears  that 
the  whole  number  of  deaths  was  411  ;  and  the  whole  number  who  had  taken 
the  small  pox  was  2112,  of  which  833  were  whites  and  1279  blacks.  Of 
the  former,  647  took  the  disease  in  the  natural  way  and  of  them  157  died. 
Of  188  whites  who  took  the  disease  by  inoculation,  nine  died.  Of  the  1279 
blacks  who  took  the  disease  1028  had  it  in  the  natural  way,  and  of  them 
138  died,  the  remainder;  253,  were  inoculated,  and  of  them  seven  died.” 

From  these  facts,  as  stated  by  Mr.  Lamboll,  it  appears  that  of  the  white 
persons  who  took  the  small  pox  in  the  natural  way,  nearly  one  in  every 
four  died  ;  but  of  such  as  took  it  by  inoculation,  the  deaths  were  only  one 
in  twenty.  Of  the  negroes  who  took  the  disease  in  the  natural  way,  nearly 
one  in  every  seven  died,  but  of  such  as  took  it  by  inoculation,  the  deaths 
were  only  one  in  thirty  six. 

Dr.  David  Bamsay,  writing  in  1808,  says,  in  reference  to  the  preceding 
facts,  that,  “It  is  well  known  that  negroes  have  the  small-pox  as  bad,  if  not 
worse,  than  white  people  when  the  treatment  of  both  is  the  . same.  That 
they  fared  better  than  their  owneis  on  this  occasion  must  be  referred  to 
their  being  under  less  restraint  with  regard  to  cold  air.  In  treating  the 
small  pox,  an  excess  of  care  and  confinement  is  much  worse  than  no  care 
or  confininent  whatever.”! 

From  the  same  manuscripts  of  Thomas  Lamboll,  it  appears  that  on  the 
twenty-first  of  September,  an  act  of  assembly  was  passed  at  Ashley  ferry 
against  inoculation  for  the  small-pox  in  Charleston,  or  within  two  miles  of 
it  after  the  tenth  of  October, §  1738. 

Dr.  David  Bamsay,  gives  the  following  account  of  the  introduction  of  the 
practice  of  inoculation  into  the  province  of  South  Carolina  during  the  pre¬ 
valence  of  small-pox  in  Charleston  in  1738. 

*An  Historical  Account  of  the  Protestant  Episcopal  Church  in  South  Carolina  etc.  by  Frederick  JJalcho, 

M.  1)  p  35. 

tHistory  of  South  Carolina,  p.  77. 

§  History  of  South  Carolina,  p.  77-78. 


200 


Small-Pox  and  Vaccination  in  South  Carolina. 


Dr.  Moybray,  a  surgeon  of  a  British  man  of  war  then  in  the  harbor,  pro¬ 
posed  inoculation  ;  but  the  physicians  opposed  it  at  first.  With  the  excep¬ 
tion  of  Dr.  Martin,  they  afterwards  came  into  it.  Mr.  Philip  Priolean  was 
the  first  person  in  Charleston  who  submitted  to  the  operation.  The  suc¬ 
cess  which  attended  this  first  experiment  encouraged  several  others  to  fol¬ 
low  the  example.  The  disease  soon  after  abated. 

Small-pox  appeared  again  in  1760. 

Dr.  Frederick  Dalcho,  records  the  facts,  that;  “the  twelfth  annual  meet¬ 
ing  of  the  clergy  was  held  April  16,  1760.  Five  clergymen  were  present  and 
eleven  were  absent.  The  small-pox  raging  in  town,  prevented  those  who 
were  subject  to  its  influence  from  attending  the  meeting.  No  sermon  was 
preached.’7 

Dr.  David  Ramsay  states,  that  “about  the  beginning  of  the  year  1760,  the 
small  pox  was  discovered  in  the  house  of  a  pilot  on  White  Point;  guards 
were  placed  round  the  house,  and  every  precaution  taken  to  prevent  the 
spreading  of  the  disease ;  but  in  vain.  When  the  persons  first  infected  at 
White  Point  were  either  dead  or  well,  the  house  in  which  they  had  lain 
was  ordered  to  be  cleaned.  In  doing  this  a  great  smoke  was  made  which, 
being  carried  by  an  easterly  wind,  propagated  the  disease  extensively  to 
the  westward  in  the  line  of  the  smoke.  Inoculation  was  resolved  upon  and 
became  general.* 

“When  this  practice  was  first  introduced,  and  for  several  years  after,  the 
inoculators  loaded  their  patients  with  mercury  and  tortured  them  with  deep 
crucial  incissions,  in  which  extraneous  substances  impregnated  with  the  va¬ 
riolous  matter  was  buried.  There  were  then  able  physicians  in  Charleston  ; 
but  they  were  so  mistaken  with  the  proper  method  of  treating  the  disease 
that  it  was  no  uncommon  practice  to  nail  blankets,  over  the  shut  windows 
of  closed  rooms,  to  exelude  every  particle  of  cool  fresh  air  from  their  va¬ 
riolous  patients,  whose  comfort  and  safety  depended  on  its  free  admission. 
The  consequences  were  fatal.  Charleston  was  a  scene  of  the  deepest  afflic¬ 
tion.  Almost  every  family  was  in  distress  for  the  loss  of  some  of  its  mem¬ 
bers,  but  so  occupied  with  the  attentions  to  the  sick  that  they  could  neith¬ 
er  indulge  the  pomp  nor  the  luxury  of  grief.  The  deaths  from  the  small¬ 
pox  was  nearly  eleven-twelfths  of  the  whole  mortality  in  Charleston.  Only 
eighty-seven  died  of  other  diseases,  while  the  deaths  from  the  small-pox 
amounted  to  nine-hundred  and  forty.  Of  these  only  ninety-two  died  under 
inbculation. 

Fifteen  hundred  persons  are  said  to  have  been  inoculated  in  one  day; 
and  it  is  certain  from  the  bills  of  mortality  that  848  persons  died  of  the  di¬ 
sease  who  were  not  inoculated.  If  we  allow  that  only  one  in  four  died,  as 
in  the  year  1738,  the  whole  number  who  took  the  disease  in  the  natural  way 
must  have  been  3392.  Precision  in  numbers  is  not  attainable;  but  enough 
is  known  and  remembered  by  several  persons  still  alive  to  prove  that  the 
year  1760  was  one  of  the  mort  melancholy  and  distressing  that  ever  took 
place  in  Charleston. 

In  the  year  1763  the  small-pox  returned;  but  as  there  were  few  to  have 
it,  and  inoculation  was  generally  adopted ;  its  ravages  were  not  extensive. 
For  seventeen  years  after,  the  small  pox  was  seldom  or  never  heard  of. 
During  the  siege  of  Charleston  it  was  introduced,  and  immediately  after 
the  surrender  of  the  town, on  the  twelfth  of  May,  1780,  a  general  inoculation 
took  place.  As  the  cool  regimen  was  then  universally  adopted,  the  disease 
passed  on  without  any  considerable  loss  or  inconvenience. 


*Au  Historical  account  of  tlie  Protestant  Episcopal  Church  p.  134. 


Small-Pox  and  Vaccination  in  South  Carolina. 


201 


“  Since  the  Revolution,  all  the  laws  which  interdicted  the  introduction 
and  spreading  of  the  small-pox  have  been  repealed.  There  have  been,,  of 
course,  some  cases  of  small-pox  almost  every  year,  but  nothing  very  gen¬ 
eral  or  alarming  in  any  one.  A  small  proportion  of  those  inoculated  died 
or  suffered  inconveniences  from  it;  but  to  nineteen  of  twenty,  it  was  a 
trifling  disorder.  This  was  a  great  triumph  of  suffering  humanity,  but  it 
was  short  of  what  followed.  In  the  yeer  1802,  vaccination  was  introduced 
into  Charleston  within  four  years  after  Doctor  Jenner  had  published 
its  efficacy  in  preventing  the  small-pox,  though  eighteen  years  had  elapsed 
between  the  first  inoculation  in  England  for  the  small-pox  and  the  adoption 
of  that  practice  in  Carolina. 

This  substitute  for  small-pox  (vaccination)  was  introduced  into  Charles¬ 
ton  by  Dr.  David  Ramsay,  who  after  many  trials  succeeded  in  February 
1802,  in  communicating  the  disease  to  his  son  Nathaniel.  From  him’ 
originally  or  remotely,  some  thousands  have  received  the  disease.  No  case 
has  yet  occurred  in  which  a  clearly  marked  case  of  small-pox  has  followed 
a  clearly  marked  case  of  vaccination.  Mistakes  have  been  made  with  re¬ 
spect  to  both  diseases,  and  the  one  has  in  some  instances  been  communi¬ 
cated  to  persons  who  had  previously  used  the  seed  of  the  other.  From 
these  causes,  added  to  the  ignorance  and  carelessness  of  some  vaccinators 
the  confidence  of  a  few  in  the  Jennerian  discovery  has  been  weakened! 
But  that  the  real  vaccine  is  a  preventive  of  the  real  small-pox  is  as  cer¬ 
tain,  from  the  testimony  and  experience  of  thousands,  as  that  the  inocu¬ 
lated  small-pox  secures  against  the  natural.  Thus  in  the  short  space  of 
seventy  years,  the  small-pox  has  been  moderated  in  Carolina  from  the 
natural  to  the  artificial.  The  latter  so  alleviated  by  mild  treatment,  and 
particularly  by  the  cool  regimen,  as  to  become  for  the  most  part 
a  trifling  disease  ;  and  finally  an  opportunity  has  been  given 
to  avoid  the  danger  and  inconvenience  of  both,  by  a  safe  and  easy 
substitute.  The  future  ravages  of  the  small-pox  may  be  fairly  put  to  the  ac¬ 
count  of  the  carelessness,  the  ignorance,  or  the  prejudices  of  the  people. 
[The  History  of  South  Carolina  from  its  first  settlement,  in  1670,  to  the 
year  1808;  in  two  volumes.  By  David  Ramsey,  M.  D. ;  Charleston,  1809  • 
pp.  78-81.] 

Small-pox  prevailed  epidemically  in  Charleston  during  the  seventeenth 
century,  in  1698  and  1699 ;  during  the  eighteenth  century,  in  1717,  1738, 
2112  persons  were  attacked,  of  whom  411,  or  20  per  cent,  died;  of  these 
833  were  whites,  1669  of  whom,  or  20  per  cent  died ;  among  the  blacks, 
1279  cases  occurred,  of  which  145,  or  12.5  per  cent  were  fatal ;  in  1760 
deaths  from  small-pox  940,  only  87  deaths  being  recorded  from  all  other 
causes  during  that  year,  the  deaths  from  small-pox  bearing  the  frightful 
proportion  of  91.52  per  cent  to  the  deaths  from  all  other  causes;  small-pox 
again  prevailed  epidemically  in  1763  and  1780. 

During  the  nineteenth  century  after  the  introduction  of  vaccination  no  ex¬ 
tensive  epidemics  are  recorded,  up  to  the  time  of  the  great  American 
civil  war,  1861-1805. 

The  absence  of  small-pox  from  Charleston  during  the  first  sixty  years  of 
the  nineteenth  century  during  which  period  vaccination  was  systematically 
and  intelligently  urged  and  practiced  by  its  learned  and  accomplished  phy¬ 
sicians  and  surgeons,  lias  been  acknowledged  by  the  medical  profession  and 
also  demonstrated  by  official  records. 

The  truth  of  the  preceding  proposition  will  be  illustrated  by  the  follow¬ 
ing  statistics  : 


202 


Small-Pox  and  Vaccination  in  South  Carolina. 


Statement  of  the  Deaths  in  Charleston,  South  Carolina,  from  all  Causes  and  from  Small-Pox 
for  Thirty-six  Years,  from  1822  to  1848,  Inclusive. 


YEARS. 

Population. 

Deaths. 

Proportion  of 
Deaths  to 
Population. 

Deaths  from  Small 
Pox. 

oj 

02 

a 

CO 

D 

r-H 

cS 

S 

b 

Total. 

One  in. 

In  100. 

White. 

Black. 

Total. 

1822 . 

24,780 

537 

388 

925 

26.7-8 

3.72 

0 

0 

0 

1823 . . 

26,301 

432 

382 

814 

32.21 

3.10 

0 

0 

0 

1824 . 

27,822 

656 

403 

1,059 

26.27 

3.80 

0 

1 

1 

1825  . 

28  233 

481 

359 

840 

33.60 

2.97 

18 

34 

52 

1826 . . 

28  644 

420 

344 

764 

37.48 

2.66 

15 

14 

29 

1827 . 

29,055 

474 

329 

803 

36.68 

2.67 

0 

0 

0 

1828  . 

29,466 

454 

339 

793 

37.15 

2.69 

0 

0 

0 

1829 . 

29,877 

388 

374 

762 

39.20 

2.55 

0 

0 

0 

1830 . 

30,289 

408 

355 

763 

39.68 

2.50 

0 

16 

16 

472 

364 

836 

33.82 

2.95 

33 

65 

98 

1831  . 

30,187 

382 

351 

733 

41.17 

2.42 

6 

36 

42 

1832 . 

30,085 

303 

257 

560 

53.72 

1.86 

0 

0 

0 

1833  . 

29,982 

281 

261 

542 

55.31 

1.80 

0 

0 

0 

1834 . 

29,879 

350 

342 

692 

43.03 

2.32 

0 

0 

0 

1835 . 

29,776 

365 

299 

664 

44.50 

2.23 

0 

0 

0 

1836 . 

29,673 

639 

533 

1,172 

25  31 

3.95 

0 

0 

0 

1837 . 

29,570 

352 

278 

630 

<18.52 

2.06 

0 

0 

0 

1838 . . 

29,467 

828 

381 

1,209 

24.36 

4.10 

0 

0 

0 

1839 . 

29,364 

502 

354 

856 

34.30 

2.91 

0 

0 

0 

1840 . 

29,261 

361 

244 

605 

46.36 

2.18 

1 

1 

2 

. 

433 

330 

766 

38.80 

2.57 

37 

44 

1841 . 

28,910 

336 

258 

594 

50.35 

1.98 

0 

i 

1 

1842 . 

28,559 

307 

243 

550 

51.83 

1.92 

0 

0 

0 

1843  . 

28,208 

368 

329 

697 

40.47 

2.47 

4 

46 

1844 . 

27,857 

282 

271 

533 

50.37 

1.98 

0 

0 

0 

1845 . 

27,596 

272 

298 

570 

48.40 

2.06 

0 

0 

0 

1846 . 

27,155 

326 

281 

607 

44.72 

2.23 

0 

0 

0 

1847 . . . 

26,803 

272 

276 

548 

48  89 

2.04 

0 

0 

0 

1848 . 

26,451 

322 

292 

614 

43.05 

2.32 

1 

0 

1 

Mean . 

310 

281 

592 

46.77 

2.13 

5 

47 

52 

Swine-Pox  occasioned  amongst  the  whites  one  death  in  1824  and  one 
death  in  1825  5  amongst  the  blacks,  one  death  in  1827  and  one  death  in 
1837  ;  total  deaths  from  Swine-Pox  in  Charleston,  South  Carolina,  during 
twenty-six  years  (1822  to  1848  inclusive),  four. 

During  the  same  period  vaccination  caused  one  death  amongst  the  whites 
in  1844,  and  one  death  amongst  the  blacks  in  1842  and  one  death  in  1844; 
total  deaths  from  vaccination  in  Charleston,  South  Carolina,  during  twen 
ty-six  years  (1822  to  1848  inclusive),  three. 

On  the  other  hand  Small-Pox  caused  deaths — whites  45,  blacks  149  j 
total,  194. 


i 


Small-Fox  and  Vaccination  in  Charleston ,  S.  C. 


203 


From  all  the  data  which  we  have  been  able  to  obtain  relative  to  the  mor¬ 
tality  of  Charleston,  South  Caroliua,  subsequent  to  1840,  we  extract  the 
following  concerning  small-pox  and  vaccination. 


YEARS. 

Population. 

Total  Deaths. 

Proportion  of 
Deaths  to  Population. 

Vaccination. 

Deaths  from 
Small-Pox. 

1844 . . . 

29,963 

553 

54.13 

2 

0 

1845 . 

29,963 

570 

52.18 

0 

0 

1846  ....  . 

607 

47  71 

o 

o 

1847 . . . . 

543 

54.74 

o 

o 

1848  . 

617 

43.11 

o 

o 

1849 . .  . . 

798 

36.34 

o 

0 

1850 . . 

No  report. 

1851  . . 

922 

44.46 

o 

4 

1852 . . 

1  582 

27.81 

o 

0 

1853 .  . 

No  report, 

1854  . 

1  876 

23.49 

o 

59 

1855  . . 

l’088 

45.94 

0 

0 

1856  . . 

No  report. 

1857  . 

1  237 

42 . 37 

o 

1 

1858  . 

1  922 

26  14 

o 

0 

1859  . 

1  033 

48 . 40 

0 

0 

I860  . 

1  472 

37.38 

0 

0 

1861 . . 

1,380 

35  09 

0 

0 

1862  1863  1864  . . 

No  reports. 

1865  . 

2.068 

9.70 

0 

138 

Of  the  138  deaths  occasioned  by  small  pox  in  1865,  eleven  were  whites 
and  137  colored.  That  small-pox  continued  to  prevail  is  indicated  from  the 
report  of  the  Health  Officer  for  1866. 

We  have  in  our  possession  the  report  of  the  Registrar  of  Charleston,  South 
Carolina,  for  only  three  months  of  1876,  April,  May  and  June ;  during  these 
months  the  deaths  from  small-pox  were,  whites  thirteen,  colored  eighty -three  ; 
total  ninety-six. 

During  the  Federal  occupation,  after  the  fall  of  Charleston,  near  the  close 
of  the  Confederate  struggle  for  independence,  the  colored  people  congregated 
in  the  city,  and  small-pox  introduced,  by  the  Federal  forces,  prevailed  to 
a  great  extent,  but  the  exact  data  is  not  in  our  posesssion  to  show  the  ac¬ 
tual  mortality  occasioned  by  this  disease: 

*  Some  conception  of  the  condition  of  affairs  in  Charleston  may  be  gather¬ 
ed  from  the  following  extracts  from  the  journals  of  1867. 


SANITARY  STATISTICS  OF  SOUTH  CAROLINA. 

Through  the  'kindness  of  the  Medical  Director  of  the  Freedmen’s  Bureau  for  South 
Carolina,  Brevet  Colonel  and  Surgeon  M  K.  Hogan,  we  have  been  permitted  to  examine 
the  Sanitary  Reports  of  Refugees  and  Freedmen,  who  have  been  receiving  medical  treat¬ 
ment  from  the  officers  of  the  Bureau.  We  procured  these  statistics  in  order  to  examine, 
from  the  most  reliable  data  within  reach,  into  the  general  condition  of  health  prevailing 
throughout  the  State,  as  well  as  in  this  city.  We  did  this  because  there  has  been  within 
the  past  few  weeks  what  we  believed  to  be  exaggerated  rumors  regarding  the  amount  of 
sickness  and  mortality  in  the  State.  As  we  have  before  stated,  “  refugees”  here  means 
indigent  whites.  These  reports  include  the  Health  Department  of  the  City  of  Charleston. 
The  following  posts  are  represented;  Charleston,  Beaufort,  Port  Royal  Island,  James’ 
Island,  Wadmalaw,  Georgetown,  Hamburg,  St.  James’  Santee,  Edisto  Island,  Mount 
Pleasant,  Summerville,  Columbia,  Hopkins’  Turnout,  Hilton  Head,  St.  Paul’s  Parish, 

‘  Legareville,  St.  Thomas’  Parish,  Monk’s  Corner,  and  Darlington.  Some  of  these  posts 
have  lately  been  discontinued.  The  reports  of  the  “Refugees,”  we  believe,  are  princi¬ 
pally  confined  to  the  white  poor  of  this  city,  and  the  freedmen,  for  the  most  part,  are  of 
Charleston  and  the  sea  islands. 

The  reports  before  us  would  he  of  great  interest  and  scientific  value  if  there  were  any 
possibility  of  determining  what  proportion  the  number  of  sick  here  reported  bears  to 
the  whole  population,  from  among  whom  these  sick  are  taken.  But  this  from  the  nature 
of  the  case,  it  is  impossible  to  ascertain.  The  numbers  purporting  to  give  this  informa¬ 
tion,  therefore,  are  necessarily  only  of  proximate  accuracy.  We  have  thought,  how¬ 
ever,  that  a  comparison  of  the  sanitary  condition  of  the  present  summer,  with  that  of 
last  year,  and  of  the  white  with  the  colored  population,  may  not  be  without  interest  to 
the  profession,  or  even  to  the  public. 


204 


Small-Pox  and  Vaccination  in  Charleston,  S.  C. 


The  consolidated  reports  of  the  several  posts  in  South  Carolina,  under  the  charge  of  the 
Freedmen’s  Bureau  (including  the  poor  white  and  black  of  Charleston),  present  us  with 
the  following  statistics : 

REFUGEES. 


1866. 

1867. 

May. 

June. 

July. 

May. 

June. 

July, 

Total  under  charge  of  Bureau _ 

2,825 

2,825 

2,925 

4T84 

4,439 

4,437 

Total  number  treated  during  month... 

585 

546 

601 

889 

626 

98' 

Died  during  the  month . 

12 

17 

8 

13 

7 

8 

Small-pox  and  Varioloid  . 

26 

9 

1 

Deaths  from  same .  .. 

1 

Typhoid  fever . . . 

2 

3 

5 

1 

3 

2 

Deaths  from  same .  . 

2 

Malarial  fevers... . 

81 

112 

169 

132 

173 

300 

Deaths  from  same .  . 

3 

2 

Consumption  .  . 

6 

9 

13 

12 

? 

5 

Deaths  from  same  .  . 

2 

1 

2 

2 

Scrofula . 

1 

1 

6 

1 

o 

4 

Deaths  from  same  . 

FREEDMEN. 


1866. 

1867. 

May. 

June. 

.  July. 

May. 

- 

June. 

July. 

Total  number  under  charge  of  Bureau 

39,099 

3,9096 

33,285 

116,135 

116,135 

116,974 

Total  number  treated  during  month.. 

5,356 

5,536 

4.522 

5,716 

5,641 

7,883 

Died  during  the  month _ 

87 

67 

63 

70 

66 

113 

Small-pox  and  Varioloid  . 

176 

271 

226 

% 

Deaths  from  same . . . 

20 

15 

10 

. 

Typhoid  fever . . . 

41 

69 

89 

10 

9 

21 

Deaths  from  same . 

6 

5 

3 

2 

3 

6 

Malarial  fever . 

603 

1,190 

1,840 

686 

1,228 

3,390 

Deaths  from  same . 

5 

8 

5 

2 

7 

23 

Consumption . 

27 

28 

33 

31 

37 

33 

Deaths  from  same..  ... 

5 

3 

4 

14 

7 

8 

Scrofula _ ....  . 

40 

35 

32 

53 

64 

63 

Deaths  from  same .  .... 

1 

1 

2 

Upon  an  examination  of  the  foregoing  tables  it  will  be  seen  that  the  amount  of  sick* 
ness  this  year  has  been  greater,  both  among  black  and  white,  in  May,  June  and  July, 
than  during  the  corresponding  months  of  last  year;  and  this  difference,  we  have  every 
reason  to  believe,  is  due  to  the  greater  preponderance  this  year  of  the  different  forms  of 
maleria  fever. 

Small-pox,  it  is  knowrn,  was  epidemic  here  during  the  winter  mouths  of  1866 — ’67,  and 
the  period  embraced  in  the  above  reports  bring  us  to  the  close  of  the  epidemic  cycle.  The 
disease  was  very  fatal,  but  during  the  summer  months,  as  usual,  its  virulence  abated,  and 
we  hence  find  that  but  few  whites  died  from  it.  The  number  of  deaths  among  the  freed  - 
men  was  greater — 11  per  cent,  in  May  ;  6  per  cent,  in  June,  and  about  4  in  July;  while 
among  the  whites,  during  the  three  months,  the  deaths  form  only  3  per  cent,  of  the  cases. 
There  is  now  not  a  single  case  of  small-pox  in  the  State  of  South  Carolina  that  we  know 
of,  nor  has  there  been  for  months. 

Typhoid  fever  did  not  prevail  to  any  alarming  degree  either  last  year  or  this.  We 
have  only  sixteen  cases  reported  among  whites,  two  of  which,  or  twelve  and  one-half  per 
cent.  died.  Among  the  freedmen,  we  note  179  cases  last  year,  with  fourteen  deaths,  and 
only  forty  cases,  with  eleven  deaths,  this  year.  The  percentage  of  mortality  last  year 
from  this  disease  was  about  eight  per  cent.,  and  this  year  twenty-seven  per  cent,  of  the 
cases  resulted  fatally,  a  very  large  mortality,  if  the  statistics  may  be  relied  upon,  * 


Small-Pox  and  Vaccination  in  Charleston ,  S.  C. 


205 


The  numbers  of  cases  of  the  different  forms  of  malarial  fevers  reported  are  not  greatly 
in  excess  this  year  over  last.  It  is  true  the  aggregate  of  cases  is  much  larger^  but  it 
should  be  observed  that,  both  among  white  and  black,  the  number  of  those  enjoying  the 
benefit  of  medical  care  from  the  Bureau  is  larger  this  year  than  it  was  last.  The  per¬ 
centage  of  malarious  diseases  this  yoar  and  last,  calculated  from  tbe  whole  number  of 
cases  treated,  is  as  follows  : 


FREEDMEN. 

REFUGEES. 

1866. 

1867. 

1866. 

1867. 

Mav . . . . 

.10 

.12 

May . .  . 

.14 

.15 

June . . . _ . . 

.21 

.21 

June . 

.20 

.27 

July . . 

.33 

.43 

July. . . 

.28 

.30 

We  find  here,  with  all  the  uncertainty  and  accidents  to  which  statistics  are  subject,  ’a 
striking  coincidence,  in  the  similarity  of  the  proportion  these  malarious  diseases  hold  to 
the  entire  number  of  diseases  reported,  in  the  two  years  under  consideration. 

Consumption  and  scrofula,  we  believe,  are  not  common  diseases  in  this  climate.  During 
the  three  months  under  consideration,  in  1866  and  1867,  we  have  52  cases  of  consumption 
reported  among  whites,  wuth  7  deaths,  or  13  per  cent.  Among  the  freedmen,  during  the 
same  period,  we  have  189  cases  and  41  deaths  or  12  per  cent.  The  percentage  of  cases  of 
consumption  among  whites,  calculated  on  the  number  of  persons  under  the  charge  of  the 
Bureau,  was  .014,  or  nearly  one  and  a  half  per  cent.,  and  among  the  freedmen  .002,  only 
one-fifth  of  one  per  cent.,  a  very  small  fraction.  Of  scrofula  only  15  cases  are  reported 
among  whites,  and  287  among  the  freedmen. 

On  the  whole,  as  far  as  we  are  able  to  judge  from  these  reports,  we  should  say  that  the 
sanitary  condition  of  South  Csrolina  is  good — much  better  than  is  supposed  by  those 
wdio  have  not  examined  the  subject. 

Perhaps,  in  conclusion,  it  maybe  well  to  state  that  there  has  not  been  this  year  a 
single  case  reported  of  any  epidemic  disease  within  the  limits  of  this  State.  There  has 
been  no  small-pox,  not  a  single  case  of  yellow-fever,  cholera,  or  even  hreakbone-fever, 
reported  this  year;  and  considering  the  lateness  of  the  season,  we  think  our  people  may 
enjoy  a  reasonable  hope  of  immunity  from  epidemic  during  the  remainder  of  the  year. 

Tlie  following  statistics  of  deaths  by  small-pox,  in  Charleston,  South 
Carolina,  during  the  fifteen  years  immediately  following  the  American  Civil 
War,  have  been  furnished  by  the  Registrar.* 


Deaths  from  Small-Pox  in  Charleston,  South  Carolina,  during  the  Fifteen  Tears  1865  to  1879 


18C5 

1866 

1867 

1868 

1869 

1870 

1871 

1872 

1873 

1874 

1875 

1876 

1877 

1878 

1879 

Total 

Whites. 

Total 

Colored. 

Total  White 
and  Colored. 

Whites 

11 

37 

0 

0 

0 

SR.' 

0 

1 

8 

3 

0 

0 

0 

0 

0 

60 

Colored 

1-27 

239 

4 

0 

0 

'  0 

0 

6 

98 

32 

0 

6 

0 

0 

0 

a12 

Total . . 

138 

276 

4 

0 

0 

0 

.  o 

7 

106 

35 

0 

6 

0 

0 

0 

60 

512 

572 

The  marked  increase  of  small-pox  amongst  the  colored  people  after  the 
Civil  War  was  referable  to  the  sudden  liberation  from  slavery,  and  the  con¬ 
sequent  freedom  of  action,  as  well  as  to  the  neglect  of  vaccination. 

From  the^p receding  facts,  it  is  evident  that  Charleston,  South  Carolina? 
wras  protected  from  the  ravages  of  small  pox  by  the  introduction  of  vaccina¬ 
tion  in  1802  by  Dr.  David  Ramsey,  and  that  the  immunity  of  this  city  from 
this  loathsome  pestilence  during  the  first  sixty-four  years  of  the  nineteenth 
century  must  be  attributed  to  the  earnest  and  philanthropic  labors  of  her 
accomplished  physicians  and  surgeons  in  the  earnest  advocacy  and  skillful 
practice  of  vaccination. 


206 


Small-Pox  and  Vaccination  in  Georgia. 


SMALL-POX  AND  VACCIXATIOX  IX  GEORGIA. 

Tlie  early  medical  history  of  Georgia,  during  the  eighteenth  century,  em¬ 
bracing  a  period  of  almost  sixty-seven  years,  has  never  been  written  ;  but 
we  are  convinced  after  careful  research  that  this  province  and  State  has 
ever  enjoyed  the  benefits  of  the  professional  skill  and  labors  of  educated, 
accomplished  and  philanthropic  medical  men.  During  the  nineteenth  cen¬ 
tury,  no  State  of  equal  white  population  in  the  American  Union  can  pro¬ 
duce  a  more  distinguished  array  of  learned  and  skillful  surgeons  and  phy¬ 
sicians,  amongst  whom  may  be  named  Drs.  Waring,  Richardson,  Kollock, 
Bullock,  Arnold,  West  and  Harris,  of  Savannah;  Dr.  Harden,  of  Liberty 
county;  Dr.  Anthony,  Dr.  Paul  F.  Eve,  L.  A.  Dugas,  Lewis  D.  Foard,  Jo¬ 
seph  Eve,  and  Henry  F.  Campbell,  of  Augusta,  Georgia  ;  and  Dr.  Long,  the 
discoverer  of  the  Anaesthetic  effect  of  Sulphuric  Ether,  of  Athens,  Georgia. 

The  first  authentic  notice  of  the  presence  of  small-pox  in  Georgia  which 
has  been  recorded  (although  the  disease  was  undoubtedly  present  at  other 
times),  was  in  the  year  1771). 

The  failure  of  the  allied  arms  to  capture  Savannah,  and  the  mutual  de¬ 
feat  and  withdrawal  of  the  French  and  American  troops,  left  Georgia  in  a 
worse  condition  than  ever ;  and  it  seemed  almost  as  if  her  political  existence 
was  at  an  end. 

The  royal  government  was  re-established  and  Sir  James  Wright  issued 
his  proclamation,  dated  Savannah,  the  twentieth  of  October,  1771). 

The  first  care  of  Sir  James  Wright  was  to  put  Savannah  into  a  proper 
condition  ;  for  it  had  been  so  shattered  by  the  destructive  tire  of  the  French 
and  Americans,  and  by  the  wanton  use  of  the  troops,  as  well  as  by  the 
necessary  demands  of  the  siege,  that  it  was  in  a  deplorable  state.  The 
churches  and  public  buildings  had  been  used  for  depots,  and  hospitals  and 
barracks  ;  private  dwellings  had  been  converted  into  mess-halls  and  officers’ 
quarters;  tire  had  laid  waste  some  squares  of  buildings;  others  had  been 
pulled  down,  to  use  the  materials  in  different  parts  of  the  fortifications  ; 
others  had  been  rendered  tenantless  by  the  battering  balls;  and  there  was 
scarcely  a  house  in  town  which  had  not  been  made  to  suffer,  outside  or  in, 
in  consequence  of  crowding  together  so  many  of  the  inhabitants,  with  sol¬ 
diers,  seamen,  and  negroes,  within  the  narrow  limits  of  the  entrenchments. 

Scarcely  had  the  town  put  on  the  aspect  of  order  and  cleanliness,  before 
the  small  pox,  broke  out  and  produced  great  consternation  amongst  the 
inhabitants  and  soldiers.  Inoculation  was  at  that  time  but  little  practiced, 
and  only  then  after  an  order  obtained  for  that  purpose  from  the  Governor’s 
Council,  who  generally  refused  to  grant  the  order,  except  the  disease  had 
already  broken  out  in  the  houshold  desiring  this  preventive  treatment. 

The  exact  date  at  which  vaccination  was  introduced  into  Georgia  is  not 
known,  but  it  was  probably  about  the  same  time  (1802)  that  it  was  practic¬ 
ed  by  Dr.. David  Ramsey  in  Charleston,  South  Carolina. 

Many  of  the  older  citizens,  who  were  known  to  me  in  my  boyhood  had 
been  inoculated  for  the  small  pox  before  the  introduction  of  Dr.  Jenner’s 
method. 

The  following  records  of  the  mortality  occasioned  by  small  pox,  in  Sa¬ 
vannah  and  Augusta,  Georgia,  which  I  have  consolidated  from  the  original 
records,  will  show  that  the  small  pox  was  almost  wholly  absent  from  the 
two  largest  and  most  important  cities  of  Georgia,  during  the  first  sixty  years 
of  the  nineteenth  century;  and  that  its  appearance  and  prevalence  was  re¬ 
ferable  to  the  assemblage  of  large  bodies  of  troops  during  the  American 
civil  war,  and  the  liberation  of  the  negro  slaves  : 


Small-Pox  and  Vaccination  in  Georgia. 


207 


Deaths  from  all  Causes  and  from  Small-pox  amongst  the  White  Population  of  Savannah,  Ga., 
during  a  period  of  fifty  years,  1804-1853,  inclusive. 


Year. 

Deaths 
from  All 
Causes. 

Deaths 
from  Small- 
Pos. 

Year. 

Deaths 
from  All 
Causes. 

Deaths 
from  Small 
Pox . 

Year. 

Deaths 
from  All 
Causes. 

Deaths 
from  Small 
Pox. 

1804 . 

207 

1 

1824 

136 

0 

1844  . 

247 

0 

1805 . 

238 

0 

1825 

126 

0 

229 

0 

1800 . 

159 

0 

1826 . 

235 

0 

1846 

240 

0 

1807  . . . 

230 

0 

1827 . 

221 

0 

1847 . 

210 

0 

1808  . . . 

219 

0 

1828 . 

146 

0 

1848 . 

298 

0 

1809 . 

183 

0 

1829  . 

209 

0 

1849  . 

357 

0 

1810 . 

163 

0 

1830 

159 

0 

1850  . 

384 

0 

1811  . 

312 

0 

1831  . 

149 

0 

1851 . 

414 

0 

1812  . 

226 

0 

1832 . 

216 

0 

1852  . 

642 

0 

1813.... 

214 

0 

1833 . 

202 

0 

1853 . 

470 

0 

1814 . 

300 

0 

1834 . 

197 

1 

1815 . 

233 

0 

1835  . 

228 

1 

Total  10  years 

,  1844-1853.. 

0 

1816 . 

272 

0 

1836 . 

249 

0 

Total  20  years 

1824-1843.. 

2 

1817 . 

461 

0 

1837  . 

358 

0 

Total  20  years 

1804-1823.. 

3 

1818 . 

211 

0 

1838 . 

331 

0 

1819 . 

510 

0 

1839  .... 

367 

0 

Total  deaths 

from  Small- 

1820 . 

817 

0 

1840 

380 

0 

pox  iu  Savannah,  (la., 

1821 . 

384 

0 

1841  ..... 

305 

0 

dinin';  fifty  years,  1804- 

5 

1822. . 

291 

0 

1842 

272 

0 

1853 . 

1823 . 

288 

0 

1843  .... 

256 

0 

Total  20 

years . . 

3 

2 

During  a  period  of  fifty  years,  1804-1843,  inclusive,  in  Savannah,  Ga., 
the  total  deaths  from  all  causes  numbered  14,322,  and  of  this  number  small¬ 
pox  occasioned  live.  The  white  population  in  1804  was  2799,  in  1808,  3010 ; 
1840,  5888  j  1843,  7250  5  1850,  8395. 


Total  Deaths  from  All  Causes,  and  from  Small-Pox,  in  the  White  and  Colored  Population  of 
Savan  nah,  Georgia,  during  a  Period  of  Sixteen  (16)  Years,  1854  to  1869,  inclusive. 


WHITES. 

BLACKS  AND  COLORED. 

WHITES,  BLACKS 
AND  COLORED. 

YEARS. 

Total  Deaths 
from 

All  Causes. 

Total  Deaths 
from 

Small-Pox. 

Total  Deaths 
from 

All  Causes. 

Total  Deaths 
from 

Small-Pox. 

Total  Deaths 
from 

All  Causes. 

Total  Deaths 
from 

Small-Pox. 

1854  . 

1,221 

0 

308 

0 

1,529 

0 

1855  . 

433 

0 

292 

0 

725 

0 

1856 . 

466 

0 

297 

0 

765 

0 

1857  . 

376 

0 

264 

0 

640 

0 

1858 . 

592 

0 

262 

0 

854 

0 

1859 . 

430 

0 

273 

0 

703 

0 

1860  . : . 

474 

0 

282 

0 

756 

0 

1861 . 

563 

0 

269 

0 

832 

0 

1862 . 

555 

0 

372 

0 

927 

0 

1863  . 

459 

0 

389 

0 

848 

0 

18G4 . 

747 

4 

446 

0 

1,193 

4 

1865 . 

1.202 

13 

819 

1 

2,021 

14 

1866 . 

530 

9 

912 

8 

1,442. 

17 

1867 . 

476 

0 

594 

1 

1,070 

1 

1868  . 

498 

1 

581 

0 

1,079 

1 

1869 . 

423 

0 

429 

0 

852 

0 

Total  deaths  from  small 
pox  during  sixteen 
years  in  Savannah, 
Ga.,  1854  to  1869 . 

27 

10 

37 

Total  deaths  from  all  causes,  whites  and  colored,  1854  to  1809,  10,234. 

A  careful  examination  of  the  mortuary  records  of  Savannah  shows  that 
it  is  difficult  to  determine  the  exact  number  of  deaths  from  yellow  lever, 
during  many  of  the  years  embraced  in  the  preceding  table,  containing  the 
deaths  amongst  the  whites  from  all  causes,  and  the  deaths  from  small-pox, 
during  a  period  of  sixty-six  years,  and  amongst  the  blacks  and  colored 
during  a  period  of  sixteen  years. 


208 


Small-Pox  and  Vaccination  in  Savannah ,  Oa. 


1804 —  One  death  is  recorded  as  due  to  yellow  fever  in  the  month  of  Octo- 
her,  whilst  inflammatory  and  putrid  fevers  caused  ten  deaths,  and  remittent 
fever  sixty-five,  intermittent  one  ;  total  seventy-seven ;  natives  fourteen, 
foreigners  sixty-three. 

1805 —  No  classification  of  fevers ;  110  deaths  being  recorded  simply  as 
fever,  two  deaths  nervous  fever;  total  112;  natives  twenty-two,  foreigners 
seventy-eight. 

1806 —  Remitting  fever  forty-one,  fever  and  ague  eleven,  total  fifty-two ; 
natives  nine,  foreigners  forty-three. 

1807 —  Fever  seventy-two,  intermittent  five,  nervous  three ;  total  eighty  ; 
natives  nine,  foreigners  seventy-one. 

1808 —  Fever  remittent  seventy,  intermittent  seven;  total  seventy-seven  ; 
natives  eight,  foreigners  sixty-nine. 

1809 —  Fever  remittent  sixty,  intermittent  one,  malignant  one,  nervous 
one;  total  sixty-tliree;  natives  nine,  foreigners  fifty-two,  unknown  two. 

1810—  Fever  remittent  forty-four;  inflammatory  one;  intermittent  one; 
natives  eight,  foreigners  thirty-eight. 

1811 —  Remittent  seventy  four,  bilious  malignant  four,  intermittent  two, 
inflammatory  one,  putrid  one,  typhus  five;  total  eighty-seven;  natives 
thirteen,  foreigners  seventy-three,  unknown  one. 

1812 —  Fever  ninety-three,  bilious  fourteen,  inflammatory  six,  endemical 
one,  putrid  two,  nervous  one,  malignant  fever  one,  black  vomit  two ;  total 
120  ;  natives  twenty-four,  foreigners  ninety-two,  unknown  four. 

We  observe  that  two  cases  are  recorded  as  black  vomit ;  and  also  that 
fever  caused  a  mortality  of  102  in  a  city  of  only  about  5,300  inhabitants. 

The  distribution  of  these  deaths  by  months  are  as  follows,  May  two,  June 
four,  July  ten,  August  eleven,  September  twenty  nine,  October  fifty, 
November  five,  December  five;  the  rise  and  decline  of  the  mortality  from  fevers 
in  1812  resembled  the  ordinary  progress  of  yellow  fever. 

1813 —  Fever  fifty-five,  bilious  two,  intermittent  three,  inflammatory 
three,  nervous  one;  total  sixty-four;  natives  nineteen,  foreigners  forty-five. 

1814 —  Fever  125,  bilious  putrid  four,  inflammatory  one,  typhus  one, 
spotted  one,  intermittent  two;  total  106;  natives  twenty-three,  foreigners  138, 
unknown  five. 

In  this  year  again  the  course  of  mortality  from  fever  resembled  that  of 
yellow  fever,  being  January  one,  March  one,  May  one,  June  eight,  July 
fifteen,  August  twenty-five,  September  fifty-five,  October  forty-six,  Novem¬ 
ber  fourteen. 

1815 —  Fever  129,  inflammatory  two,  nervous  two  ;  total  130  ;  natives 
eighteen,  foreigners  104,  unknown  eight, 

1816 —  Fever  134,  bilious  three,  putrid  one,  intermittent  six,  typhus  one, 
yellow  one;  total  146;  natives  thirty-eight,  foreigners  ninety-one. 

1817 —  Fever  304,  bilious  four,  inflammatory  one,  yellow  two,  typhus 
two ;  total  311 ;  natives  fifty-seven,  foreigners  236,  unknown  twenty. 

Amongst  this  large  number  of  deaths  from  fever,  only  two  were  indicated 
as  yellow;  the  deaths  by  months  from  fever,  were  as  follows  :  January  four, 
February  five,  March  two,  June  eight,  July  forty-five,  August  thirty- 
seven,  September  forty-six,  October  104,  November  forty-seven,  December 
thirteen. 

1818 —  Fever  seventy-four,  nervous  two;  total  seventy-six ;  natives  thir¬ 
teen,  foreigners  sixty,  unknown  three. 

1819 —  Fever  322,  black  vomit  one;  total  323;  natives  thirty-three,  for¬ 
eigners  285,  unknown  five.  The  monthly  mortality  from  fever  was  as  follows: 


Small-Pox  and  Vaccination  in  Savannah ,  Oa. 


209 


March  one,  April  three,  June  four,  July  twenty-four,  August  twenty- 
eight,  September,  sixty-six,  October  147,  November  forty,  December  nine, 
total  323. 

The  first  acknowledged  and  undoubted  epidemic  of  yellow  fever  in 
Savannah,  Georgia,  during  the  first  twenty  years  of  the  nineteenth  century 
occurred  in  1820. 

1820 — Fever  626,  yellow  fever  two,  black  vomit  ten,  intermittent  one; 
total  deaths  from  fever  649;  natives  116,  foreigners  502,  unknown  thirty- 
one.  The  deaths  from  fever  were  distributed  as  follows  :  January  four,  Feb¬ 
ruary  four,  March  one,  May  three,  June  fourteen,  July  thirty-nine,  August 
110,  September  214,  October  197,  November  fifty-three,  December  ten. 

It  is  remarkable  that  upon  the  mortality  record,  only  two  cases  were 
recorded  as  due  to  yellow  fever. 

The  following  table  presents  the  total  deaths  from  fever  and  other  causes 
in  Savannah,  Georgia,  during  a  period  of  fifty  years,  1804-1853,  inclusive, 
amongst  the  white  inhabitants  : 


YEARS. 

Total  Deaths 
from  Fevers. 

Total  Deaths 
from  All 
Other  Causes. 

1804 . . . . 

77 

130 

1805 . 

112 

126 

1806 .  . 

52 

107 

1807 . . 

80 

150 

1808 . 

77 

142 

1809 . 

63 

120 

1810 . 

46 

117 

1811 . 

87 

125 

1812 . 

120 

106 

1813 . 

64 

150 

1814  . 

166 

134 

1815  . . 

130 

103 

1816  . 

146 

126 

1817. . 

313 

148 

1818  . 

76 

135 

1819 

323 

187 

1820 . 

649 

168 

1821  . 

183 

202 

1822  . 

133 

158 

1823  . 

109 

159 

1824  . 

42 

94 

1825 . 

23 

103 

1826 . 

62 

173 

1827 . 

96 

225 

1828  . . . 

23 

123 

Total  fifty  years 


YEARS. 

Total  Deaths 
from  Fevers. 

Total  Deaths 
from  All 
Other  Causes. 

1829  . 

32 

177 

1830 . 

28 

139 

1831  . 

17 

139 

1832 . 

57 

159 

1833  . 

36 

166 

1834  . . 

34 

163 

1835  . 

57 

171 

1836  . . 

38 

211 

1837 . 

100 

258 

1838  . 

108 

163 

1839  . . 

154 

213 

1840  .  ... 

124 

256 

1841  . 

83 

222 

1842  . 

62 

210 

1843 . 

91 

165 

1844  .  ... 

51 

196 

1845  . . 

57 

172 

1846  . 

60 

180 

1847 . 

28 

182 

1848  . 

50 

148 

1849 . 

71 

286 

1850  . . 

63 

321 

1851 . .» . 

75 

339 

1852.... . 

202 

440 

1853 . 

76 

394 

4,888  9,444 


Total  deaths  from  all  causes,  14,332. 


Table — Deaths  from  Malarial  Fever  and  from  Yellow  Fever  in  Savannah,  Georgia,  During  a 

Period  of  Sixteen  Years,  1854-1869  ;  Whites. 


YEAR. 

DEATHS. 

YEAR. 

DEATHS. 

YEAR. 

DEATHS. 

Malarial 

Fever. 

Yellow 

Fever. 

Malarial 

Fever. 

Yellow 

Fever. 

Malarial 

Fever. 

(s  p 

®  % 

73  Ph 

1854  . 

115 

625 

1860 . 

59 

o 

18G6 . 

48 

5 

1855  . 

60 

0 

1861 . 

80 

4 

1867  . 

67 

0 

1856  . 

86 

0 

1862 . 

53 

o 

1868 . 

52 

1 

1857  . 

0 

1863  . 

35 

o 

1869  . 

36 

J 

1858 

7G 

112 

1  ftfU 

97 

14 

1859  . 

49 

0 

1865  . 

103 

i 

Total . 

1,071 

763 

210 


Small-Pox  and  Vaccination  in  Savannah ,  Ga. 


Table — Deaths  from  Malarial  Fever  and  from  Yellow  Fever  in  Savannah,  Georgia,  During 

Sixteen  Years,  1854-1869;  Blacks  and  Colored. 


YEAH. 

DEATHS. 

YEAR. 

1 

DEATHS. 

YEAR. 

DEATHS. 

Malarial 

E  ever. 

g  £ 

©  to 

Malarial 

Fever. 

1 

i  Yellow 

1  „ 

j  .  Fever. 

i 

r—*  f  * 

.«  © 

«  Ph 

.  f-4 

O  ^ 

©  Ph 

1854 . 

23 

14 

i  afio . 

8 

0 

1866 . 

50 

0 

1855 . 

9 

o 

1861 . 

3 

0 

1867 . 

43 

0 

1856 . . 

40 

o 

1862 . 

14 

0 

1868 . 

34 

0 

1857 . 

5 

0 

1863. . . 

19 

0 

1869 . 

22 

0 

1 858 . 

7 

2 

1864 

20 

2 

1859 . 

9 

0 

1865 . 

120 

0 

Total . 

396 

18 

The  total  deaths  amongst  the  whites  during  the  period  specified  (1856- 
1869)  were  9,445 ;  amongst  the  blacks  and  colored,  6,789 ;  grand  total 
whites  and  blacks,  16,234. 

In  1827  sixteen  deaths  from  yellow-fever  were  recorded,  and  seventeen 
deaths  from  malignant  fever ;  total  from  yellow  and  malignant  fever,  33. 
The  deaths  from  these  causes  were  distributed  as  follows :  September,  ten  ; 
October,  nineteen ;  November,  tour.  Fever  was  credited  with  filly  deaths — 
intermittent,  six;  nervous,  four;  typhus,  three;  total,  ninety-six;  natives, 
sixteen;  foreigners,  seventy-eight;  unknown,  two. 

In  1839,  when  the  yellow-fever  prevailed  in  a  fatal  form  in  Augusta, 
Georgia,  yellow-fever  does  not  appear  amongst  the  list  of  fatal  fevers. 
The  deaths  from  fevers  were  classified  as  follows :  Fever,  139 ;  intermit¬ 
tent,  three;  malignant,  eleven;  nervous,  one;  total  deaths  from  fevers, 
154  ;  natives,  fifteen ;  foreigners,  137 ;  unknown,  two. 

It  is  probable  that  a  portion  of  the  deaths  (154)  recorded  as  fever  and 
malignant  fever,  etc.,  were  yellow-fever. 

In  1876,  during  the  months  of  August,  September,  October  and  Novem¬ 
ber,  yellow-fever  caused  896  deaths,  and  other  diseases  455 ;  total,  1,351. 
The  following  is  the  official  record  as  prepared  by  Dr.  William  Duncan, 
and  embodied  in  the  annual  report  of  Hon.  Edward  0.  Anderson,  Mayor 
of  the  city  of  Savannah  for  the  year  1877. 


Deaths  from  Yellow  Fever  and  other  diseases  in  Savannah,  Georgia,  during  the  months  of 

August,  September,  October  and  November. 


1876. 

WHITES. 

COLORED. 

TOTAL. 

Yellow 

Other  Dis- 

Yellow 

Other  Dis- 

Whites  and 

Months. 

Fever. 

eases. 

Total . 

Fever. 

eases . 

Total. 

Colored. 

August . 

35 

25 

59 

2 

19 

21 

80 

September . 

483 

66 

549 

66 

137 

201 

752 

October . 

212 

54 

266 

52 

109 

161 

427 

November . 

41 

16 

57 

5 

30 

35 

92 

Total . 

771 

160 

981 

125 

295 

420 

1,351 

Total  yellow  fever,  896 ;  other  diseases,  455  ;  grand  total,  1351. 

If  the  deaths  from  fevers  occurring  in  the  months  of  June,  July,  August, 
September,  October  and  November  and  December  in  1820,  be  regarded  as 
yellow  fever  (an  estimate  above  rather  than  below  the  true  number  of 
deaths  occasioned  by  this  disease),  then  we  have  637,  as  the  yellow  fever 
mortality  of  that  year ;  and  if  we  add  the  deaths  from  yellow  fever  in 
1854,  639  ;  1858,  114,  and  1876,  896,  the  total  deaths  from  yellow  fever  in 
Savannah,  Georgia,  during  a  period  of  seventy-three  years,  1804  1876, 
would  number : 


Small-Pox  and  Vaccination  in  Augusta ,  Ga. 


211 


1820 .  637  11858 . T.  114 

1854 .  639  |  1876 .  896 

Total .  1,276  |  Grand  total . 2,286 

Before  the  introduction  of  vaccination  a  large  proportion  of  the  deaths 
was  caused  by  small-pox,  and  yet  the  official  mortuary  records  of  the  city 
of  Savannah  show  that,  during  a  period  of  sixty-six  years,  1804  to  1869, 
the  deaths  from  small  pox  reached  only  forty-two  out  of  a  total  of  deaths 
from  all  causes :  Whites,  1804  to  1853,  14,332 ;  whites  and  colored,  1854  to 
1869,  16,234 ;  total,  30,566. 

Whilst  the  various  forms  of  fevers  destroyed  amongst  the  whites  during 
fifty  years,  1804  to  1853,  4,888  ;  whites  and  blacks,  sixteen  years,  1854  to 
1869,  2,626;  total,  7,514. 

The  statistics  of  Savannah  show  that  the  colored  race  are  far  less  liable 
to  the  various  forms  of  miasmatic  fevers  and  yellow-fever.  This  immunity 
does  not  extend  to  small-pox,  which,  on  the  other  hand,  proves  very  de¬ 
structive  to  the  colored  race. 

We  must  attribute  the  remarkable  immunity  of  the  white  and  black 
races  of  Savannah,  Georgia,  during  the  nineteenth  century,  from  the  rav¬ 
ages  of  small-pox  to  the  faithful  performance  of  vaccination  and  revaccin¬ 
ation  by  the  medical  profession ;  and  the  results  of  their  labors  iu  this 
respect  have  been  placed  in  bold  relief  by  the  record  of  the  preceding  mor¬ 
tuary  statistics?  illustrating  the  ravages  committed  by  yellow-fever  and 
malarial  fever,  during  the  period  taken  under  consideration. 


SMALL  POX  AND  VACCINATION  IN  AUGUSTA,  GEORGIA. 


Deaths  from  All  Causes  and  from  Small-Pox,  Whites  and  Blachs,  in  Augusta,  Georgia,  during 

Forty-eight  Years,  1818  to  18fi6. 


YEARS. 

Total  Deaths 
from 

All  Causes. 

Deaths  from 
Small-Pox. 

YEARS. 

Total  Deaths 
from 

All  Causes. 

Deaths  from 
Small-Pox. 

1818 . 

90 

o 

1842 . 

71 

o 

1819 . 

118 

o 

1843  . 

80 

o 

1820 . 

126 

o 

1844... o  . 

105 

o 

1821 . 

127 

o 

1845 . 

139 

0 

1822 . 

145 

o 

1846 . 

185 

o 

1823 . . . 

109 

0 

1847 . 

168 

0 

1824  . 

90 

o 

1848 .  . 

236 

0 

1825. . . .  . . 

127 

o 

1849 . 

243 

o 

1826 . 

117 

0 

1850 . 

328 

1 

1827  . 

134 

o 

1851 . 

363 

7 

1828  . 

91 

o 

1852 . 

410 

0 

1829  . . 

94 

o 

1853 .  .... 

372 

0 

1830  . 

71 

0 

1854 . . 

538 

1 

1831  . 

152 

o 

1855 . 

364 

0 

1832  . . , 

104 

o 

1856 . 

367 

0 

1833  . 

129 

o 

1857 . 

421 

0 

1 834  . 

75 

o 

1858 . 

333 

0 

1835  . . . 

105 

o 

1859  . 

349 

0 

1836  . 

107 

o 

1  ftfio  . 

395 

0 

1837  . 

150 

o 

1861 . 

432 

0 

1838 . . . 

95 

o 

1862  . 

638 

0 

1839 . 

340 

o 

1863 . 

687 

5 

1840 . 

93 

0 

1864 . 

827 

0 

1841  . 

55 

0 

1865 . 

1,490 

82 

In'  1865  the  deaths  from  small-pox  amongst  the  whites  was  eight,  and 
amongst  the  colored  people  seventy-four. 

The  disease  continued  to  prevail  in  August,  during  1866  ;  we  have  the 
record  for  only  the  first  six  months  of  this  year  (1866,  January,  February, 
March,  April,  May  and  June),  and  during  this  period  the  deaths  numbered, 
whites,  37  ;  blacks,  260 ;  total,  297. 


212 


Introduction  of  Vaccination  into  Spanish  America. 


'She  negroes,  suddenly  set  free  by  the  results  of  the  civil  war,  flocked 
into  the  cities  to  receive  Federal  aid  ;  and  in  their  destitute,  filthy  and 
crowded  condition,  fell  easy  victims  to  small-pox. 

During  a  period  of  forty-six  years,  1817-1864,  inclusive,  the  deaths  from 
small  pox  in  Augusta,  Georgia,  numbered  only  fourteen,  notwithstanding 
that  the  disease  was  introduced  in  1850-1851,  1854  and  1863.  Its  suppres¬ 
sion  must  be  referred  to  the  untiring  etforts  of  the  skillful  physicians,  in 
protecting  the  people  by  vaccination. 

During  the  year  1865  and  the  first  six'  months  of  1866,  forty-five  whites 
and  334  colored  people  perished  by  the  disease;  total,  379. 

Since  its  foundation  up  t©  the  present  date,  January,  1884,  Augusta  has 
suffered  with  two  epidemics  of  yellow  fever  ;  namely,  in  1.839  and  1854. 

The  mortuary  records  show  the  following  mortality  occasioned  by  yellow 
fever  in  Augusta,  Georgia : 


Deaths  by  Yellow  Fever  in  Augusta, 

Ga.,  1839. 

Deaths  by  Yellow  Fever  in  Augusta,  Ga., 

1854. 

MONTHS. 

Deaths. 

MONTHS. 

Whites. 

Colored. 

Total. 

1 

4 

49 

27 

52 

7 

59 

148 

12 

2 

14 

52 

o 

0 

0 

16 

i 

Total . 

109 

13 

122 

Total .  . 

245 

Total  deaths  from  yellow  fever  in  1839  and  1854,  367. 

The  small-pox  ot  1865-1866  (first  six  months),  destroyed  379  lives,  or 
twelve  more  than  the  mortality  of  the  yellow  fever  epidemics  of  1839 
and  1854,  which  struck  terror  into  the  hearts  of  the  people. 

Yellow  fever  strikes  down  the  most  prominent  and  useful  citizens,  and 
concentrates  its  Ravages  upon  the  white  race;  small-pox  since  the  introduc¬ 
tion  of  vaccination  confines  its  attacks  almost  exclusively  to  the  unvaccin- 
nated,  and  to  the  poor  and  filthy  in  crowded  houses.  Hence  the  former 
disease  excites  more  terror  and  alarm  than  the  latter. 


INTRODUCTION  OF  VACCINATION  INTO  THE  POSSESSIONS  OF 
SPAIN  IN  NORTH  AND  SOUTH  AMERICA. 

Father  Torribio  says,  that  the  small-pox,  introduced  by  a  negro  slave  of 
Navarez  attached  to  the  Spanish  forces,  in  1520,  carried  off  half  the  inhabi¬ 
tants  of  Mexico.  Torquemada  states,  that  the  Matlazahuati  carried  off 
800,000  Indians  in  1545,  and  2,000,000  in  1576 ;  but  Alexander  Humboldt, 
justly  observes  that  these  numbers  must  be  in  a  great  measure  conjectural. 
He  also  remarks,  that  there  is  an  interesting  problem  to  be  solved.  Was 
the  plague,  which  is  said  to  have  ravaged  the  Atlantic  regions  of  the  United 
States,  prior  to  the  arrival  of  the  Europeans,  and  which  Dr.  Rush  and  his 
followers  consider  as  the  origin  of  the  yellow  fever,  the  same  with  the 
Matlazahuati  of  the  Mexicans  ? 

According  to  Humboldt,*  small  pox,  introduced  into  Mexico  in  1520, 
commits  its  ravages  only  every  seventeen  or  eighteen  years.  In  equinoctial 
countries,  like  the  black  vomit  and  several  other  diseases,  it  seems  to  have 
regular  periods  of  recurrence;  for,  although  frequently  introduced  by  ship¬ 
ping  from  Europe,  it  does  not  become  epidemic  but  at  well-marked  inter- 

*Voyage  d’ Alexandre  de  Humboldt,  et  Aime  Bonpland.  Esai  Statisque  sur  la  Nouvelle  Espagne,  4  to. 
Paris,  1808. 


Introduction  of  Vaccination  into  Spanish  America. 


213 


vals.  It  committed  terrible  ravages  in  1763,  and  especially  in  1779.  In 
tliat  year  it  carried  off  more  than  9,000  in  the  City  of  Mexico  alone.  The 
epidemic  of  1797  was  less  fatal,  chiefly  on  account  of  the  attention  and  zeal 
with  which  inoculation  was  propagated.  In  the  city  of  Valladolid,  the 
capital  of  Mechoacan,  of  6,800  inoculated ,  only  170  died,  and  many  of  these 
had  probably  been  previously  infected.  In  the  whole  kingdom  60,000  were 
inoculated* 

Vaccination  was  unknown  at  Lima,  Peru,  till  the  month  of  November, 
1802.  At  that  period  tile  small-pox  prevailed  on  the  coast  of  the  South  Sea. 
A  merchant  vessel,  Santo  Domingo  de  la  Galzada ,  put  into  Lima,  on  the  pas' 
sage  from  Spain  to  Manilla.  An  individual  had  had  the  good  sense  to  send 
by  this  vessel  vaccine  matter  to  thePhilipine  Islands.  They  availed  them¬ 
selves  of  this  opportunity  at  Lima;  and  M.  Unanue,f  professor  of  anatomy 
and  author  of  a  work  on  the  climate  and  diseases  of  Peru,  vaccinated  several 
individuals  by  matter  brought  by  the  merchant  vessel. 

No  pustule  appeared,  and  the  virus  appeared  either  altered  or  too  weak. 
However,  M.  Unanue  having  observed  that  all  the  vaccinated  individuals 
had  a  very  mild  small-pox,  employed  this  variolous  matter  to  render,  if 
possible,  by  the  ordinary  inoculation  the  disease  less  fatal.  He  thus  per¬ 
ceived  in  an  indirect  way  the  effects  of  a  vaccination  supposed  to  have 
failed/. 

It  is  also  stated  by  M.  Humboldt  that  in  1802  it  was  discovered  that  the 
cow-pox  was  known  to  the  peasantry  in  the  Peruvian  Andes.  A  negro  slave 
in  the  family  of  the  Marquis  Valleumbroso  was  inoculated  with  small-pox, 
but  ineffectually.  They  were  going  to  repeat  the  inoculation,  when  the 
young  man  declared  that  he  was  very  certain  he  would  never  take  the 
small-pox,  because  in  milking  the  cows  of  the  Cordilleras  of  the  Andes  lie 
had  had  a  sort  of  cutaneous  eruption,  caused,  as  the  old  Indian  herdsmen 
said,  by  certain  tubercles  which  are  sometimes  found  on  the  teats  of  the 
cow.  “  Those  who  have  had  this  eruption,”  said  the  negro,  “  never  take 
the  small-pox.”  The  Africans,  and  especially  the  Indians,  evince  great 
sagacity  in  observing  the  characters,  manners  and  diseases  of  their  domes¬ 
tic  animals.  It  is  not,  therefore,  astonishing  that  after  the  introduction  of 
diseased  cattle  into  America,  the  common  people  should  have  remarked 
that  the  pustules  upon  the  cow’s  teats  should  communicate  a  sort  of  mild 
small-pox,  and  that  those  who  had.  it  should  escape  the  general  contagion 
during  epidemics. 

In  the. month  of  January,  1804,  the  vaccine  inoculation  was  introduced 
at  Mexico  through  the  activity  of  Don  Thomas  Murphy,  who  brought  the 
virus  from  North  America.  This  introduction  found  few  obstacles ;  the 
cow-pox  appeared  under  the  aspect  of  a  very  mihl  malady;  and  the  small¬ 
pox  inoculation  had  already  accustomed  the  Indians  to  the  idea  that  it 
might  be  useful  to  submit  to  a  temporary  evil  for  the  sake  of  evading  a 
greater  evil. 

Alexander  Humboldt  affirms,  that  if  the  vaccine  inoculation,  or  even  the 
ordinary  inoculation,  had  been  known  in  the  New  World  in  the  sixteenth 
century,  several  millions  of  Indians  would  not  have  perished  victims  to  the 
small  pox,  and  particularly  to  the  absurd  treatment  by  which  the  disease 
was  rendered  so  fatal. 

To  this  disease  the  fearful  diminution  of  the  number  of  Indians  in  Cali¬ 
fornia  is  to  be  ascribed. 

’'Fifteen  in  the  hundred  died  of  individuals  of  all  ages,  who,  without  being  inoculated,  were  victims  of 
the  natural  small  pox. 

tObsorvaeiones  sobre  el  clima  de  Lima,  y  sus  influencias  en  los  seres  organizados  en  especial,  el  hombre’ 
por  el  Doctor  Don  Hijwlito  Dnanue,  Catedratico  de  Prim*  de  Medecina,  en  la  Real  TJniversidad  de  San 
Marcos.  Direotor  del  Colegio  de  Medecina  y  Cirurgia  de  San  Fernando,  Medico  Honorario  de  Camara  de  S. 
M,,  Socio  de  la  Real  Acadomia  Medico  Matritense.  Proto  Medico  del  Peru,  secunda  edicion,  Madrid,  1815. 


214 


Introduction  of  Vaccination  into  Spanish  America. 


The  ships  of  war  commissioned  to  carry  the  vaccine  matter  into  America 
and  Asia  arrived  at  Vera  Cruz  shortly  after  the  arrival  of  Alexander  Hum¬ 
boldt. 

Don  Antonio  Valmis,  Physician  General  of  this  expedition,  Adsited 
Porto  Pico,  Cuba,  Mexico  and  the  Philippine  Islands;  and  his  stay  at 
Mexico,  where,  nevertheless,  the  coA\T-pox  was  known  before  his  arrival, 
contributed  singularly  to  facilitate  the  propagation  of  this  notable  prevent 
ive  of  the  small-pox.  In  the  principal  cities  of  the  kingdom,  Vacciu- 
Committies  were  formed,  who  by  vaccinating  monthly,  preseiwed  the  virus 
from  being  lost. 

M.  Valmis  discoArered  cow-pox  in  the  environs  of  Valladolid,  and  in  the 
village  of  Atlisco,  near  Puebla,  in  the  udder  of  the  Mexican  cows. 

This  fact  renders  the  story  of  the  presence  of  cow-pox  in  the  Peruvian 
Andes  less  improbable,  for  the  Hindostau  relation  of  a  similar  kind  was  a 
mere  fabrication  to  impose  a  belief  of  their  great  sagacity. 

The  persons  attached  to  the  expedition  of  Dr.  Francis  X.  de  Valmis,  honor¬ 
ary  surgeon  of  the  Royal  Chamber,  were  several  physicians,  with  assistants, 
and  twenty -two  children,  who  had  not  had  the  small-pox,  and  were  destined 
to  preserve  the  Amluable  fluid  by  a  successive  vaccination  from  arm  to  arm, 
or  one  after  another  in  the  course  of  the  voyage.  They  sailed  from  the  port 
of  Corunna,  under  the  direction  of  Dr.  Valmis  on  the  twentieth  of  Xo\rember, 
1803.  They  ftrst  touched  at  the  Canaries,  then  at  Porto  Rico,  and  from 
thence  proceeded  to  Carracas.  On  leaving  the  port  of  Laguaira  in  that  pro- 
Aince,  they  separated  into  two  parties,  the  one  sailing  for  South  America, 
under  the  care  of  the  sub-director,  Dr.  Francis  Salvani ;  the  other  under 
Dr.  Valmis  for  the  Havannahs,  and  from  thence  to  Yucatan.  In  this  pro- 
Aflnce  they  again  made  a  division.  Dr.  Francis  Pastor  proceeded  from  the 
port  of  Sisal  to  that  of  Villahexmosa  in  the  province  of  Tabasco,  to  propa¬ 
gate  vaccination  in  the  royal  city  of  Chiapa,  and  as  far  as  Guatemala,  pas¬ 
sing  through  a  tedious  and  rough  country  for  400  leagues  to  Oaxaca  ; 
whilst  the  other  party  arriving  safely,  at  Vera  Cruz,  not  only  passed  through 
the  whole  viceroyship  of  Xew  Spain  but  the  interior* provinces,  from 
whence  they  were  to  return  to  Mexico,  which  aa?us  the  point  of  reunion. 
Having  profusely  disseminated  this  preventive  from  the  natural  small¬ 
pox,  through  the  northern  parts  of  Spanish  America,  to  the  coasts  of 
Sonora  and  Sinaloa  ;  and  having  established  in  each  capital  a  central  society 
composed  of  the  highest  authorities  and  most  zealous  medical  characters,  to 
presreve  it  as  a  sacred  deposit,  for  Avhicli  they  were  ansAverable  to  the 
King  of  Spain  and  posterity,  the  Director  determined  that  this  part  of  the 
expedition,  which  had  been  crowned  with  success,  should  carry  to  Asia  the 
vuccine  virus,  and  having  overcome  some  difficulties,  Dr.  Valmis  embarked 
at  Acapulco  for  the  Philippine  Islands. 

Dr.  Valmis  accomplished  this  passage  in  little  more  than  two  months, 
taking  with  him  from  Xew  Spain  twenty-six  children  to  be  successively 
ATaccinated;  and,  as  many  of  them  were  very  small,  they  were  placed  un¬ 
der  the  charge  of  a  matron  from  the  orphan  house  of  Corunna;  and  in  this, 
as  in  former  voyages,  the  greatest  attention  was  paid  to  their  cleanliness 
and  comfort.  The  expedition  having  arrived  at  the  Philippine  Islands, 
propagated  the  variola;  vaccinra  through  the  islands  subject  to  his  Spanish 
Majesty. 

Dr.  Valmis,  having  thus  closed  his  philanthropic  mission,  resolved,  with 
the  consent  of  the  Captain  General,  to  extend  the  beneficience  of  his  King 
and  the  glo^y  of  his  august  name  to  the  utmost  coniines  of  Asia. 


Introduction  of  Vaccination  into  Spanish  America. 


215 


In  consequence  vaccination  was  introduced  through  the  vast  Archipelago 
of  the  Visayas  Islands.  When  Valmis  arrived  at  Macao  and  Canton,  he 
succeeded  in  introducing  fresh  and  active  vaccine  matter  into  the  Chinese 
Empire,  by  the  means  already  pointed  out. 

After  having  extended  vaccination  in  Canton  as  much  as  possible,  under 
the  political  regulations  of  that  empire,  and  leaving  its  propagation  to  the 
English  factory  in  that  place,  Yalmis  returned  to  Macao,  and  embarked  for 
Lisbon,  where  he  arrived  on  the  fifteenth  of  August,  1806. 

That  part  of  the  expedition  which  was  destined  for  Peru,  under  the  di¬ 
rection  of  Salvani,  was  wrecked  in  one  of  the  mouths  of  the  River  Made- 
laine;  but  being  quickly  succored  by  the  natives,  the  magistrates  of  the 
neighborhood  and  the  government  of  Carthagena,  they  saved  the  sub- 
director,  three  physicians  who  accompanied  him,  and  the  children,  with  the 
fluid  in  a  proper  state,  which  they  successfully  spread  in  that  port  and 
province.  From  thence  they  transmitted  it  to  the  Isthmus  of  Panama,  and 
undertaking  the  troublesome  navigation  of  the  River  Madelaine,  they 
passed  the  time  necessary  on  its  respective  banks;  they  penetrated  repeat- 
edl}r  into  the  country  to  fulfill  their  commission  in  the  towns  of  Teneriffe, 
etc.,  etc.,  in  the  valley  of  Cucuta,  and  in  the  city  ot  Pampelona  and  other 
populous  places,  until  they  rejoined  each  other  at  St.  Fee.  They  gave  full 
information  to  the  medical  men  wherever  they  went,  and  laid  down  regula¬ 
tions  agreeably  to  the  instructions  of  the  director,  in  order  to  preserve  the 
vaccine  virus,  which,  from  the  account  of  the  Viceroy,  they  communicated 
to  50,000  persons  without  one  unpleasant  accident. 

Towards  the  end  of  March,  1805,  they  prepared  to  continue  their  journey, 
taking  different  and  separate  routes,  to  pass  with  more  expedition  and 
facility  through  the  other  towns  of  the  Viceroy  ship,  situated  on  the  road 
to  Popayan,  Ouenea  and  Quito,  and  so  on  to  Lima;  and  in  the  following 
August  they  arrived  at  Guayaquil.  This  expedition  not  only  succeeded  in 
propagating  vaccination  throughout  countries  adverse  as  well  as  friendly, 
but,  in  the  dominions  of  the  King  of  Spain,  they  assured  the  perpetuity  of 
the  blessing  by  the  establishment  of  the  central  societies,  and  also  by  the 
discovery  of  Dr.  Valmis  of  the  existence  of  the  cow-pox  in  the  Valley  of 
Atlixco,  near  the  city  of  Puebla  of  the  Angels,  and  in  the  neighborhood  of 
the  city  of  Valladolid  de  Meehoacan,  where  it  was  discovered  by  the  Assist¬ 
ant,  Dr.  Antonio  de  Gutierrez,  and  in  the  district  of  Calabozo  in  the  prov¬ 
ince  of  Carracas,  where  it  was  found  by  Dr.  Carlos  de  Pozo,  a  physician 
established  there.* 

The  voyage  of  M.  Valmis,  will  thus  remain  forever  memorable  in  the  an¬ 
nals  of  history. 

The  Indies  saw  for  the  first  time  three  vessels,  which  were  formerly 
freighted  only  with  the  instruments  of  carnage  and  destruction,  bearing 
about  the  germs  of  relief  and  consolation  to  distressed  and  suffering  hu¬ 
manity. 

The  arrival  of  the  armed  frigates  in  which  M.  Valmis  made  the  circuit  of 
the  Atlantic  and  Pacific  Oceans,  gave  rise  on  several  coasts  to  one  of  the 
most  simple  and  affecting  ceremonies.  The  bishops,  military  governors,  and 
persons  of  greatest  distinction  repaired  to  the  shore,  where  they  took  in  their 
arms  the  children  who  were  to  carry  the  cow-pox  to  the  indigenous  Ameri¬ 
cans  and  the  Malays  of  the  Philippine  Islands,  and  followed  with  public 
acclamations,  they  laid  at  the  foot  of  the  altar  those  precious  preservative 
deposits,  returning  thanks  to  the  Supreme  Being  for  having  been  the  wit¬ 
nesses  of  so  happj  an  event.  We  must  have  some  knowledge  of  the  ravages 

‘Supplement  to  the  Madrid  Gazette,  October  14,  1806,  Pliila.  Medical  Museum  ;  vol.  3;  1807;  p.  237. 


216 


Relations  of  Grease  to  Coic-Pox. 


occasioned  by  the  small-pox  in  the  torrid  zone,  and  especially  among  a  race 
of  men  whose  physical  constitution  seems  adverse  to  cutaneous  eruptions, 
in  order  to  feel  all  the  importance  of  Dr.  Edward  Jenner’s  discovery.  It 
appeared  to  be  a  much  greater  blessing  for  the  equinoctial  part  of  the 
New  Continent  than  for  the  temperate  climate  of  the  Old.* 


THE  RELATIONS  OF  GREASE  IN  THE  HORSES’  HEELS  TO 

COW-POX. 

Horse-Pox. — The  facts  concerning  the  origin  of  the  cow-pox  were  inves¬ 
tigated  by  Edward  Jenner  before  the  publication  Of  his  “  Inquiry.”  His 
nephew,  George  Jenner,  in  the  year  1787,  went  into  the  stable  with  him  to 
look  at  a  horse  with  diseased  heels.  “There,”  said  he,  pointing  to  the 
horse’s  heels,  “  is  the  source  of  small  pox.  I  have  much  to  say  on  that 
subject,  which  I  hope  in  due  time  to  give  to  the  world.” 

Writing  to  a  friend  in  1794,  Jenner  observes: 

“Our  friends  at  our  last  meeting  treated  my  discovery  of  the  origin  of  the  cow-pox  as 
chimerical.  Further  investigation  lias  convinced  me  of  the  truth  of  my  assertion  beyond 
the  possibility  of  a  denial.  Domestication  of  animals  lias  certainly  proved  a  prolific 
source  of  disease  among  men.  But  I  must  not  anticipate  ;  you  shall  have  a  paper.” 

Subsequently  to  this  letter,  and  before  the  publication  of  his  “  Inquiry,” 
in  1798,  Jenner  made  many  experiments  in  order  to  determine  the  connec¬ 
tion  between  the  grease  and  the  cow-pox  ;  but  difficulties  of  a  nature  not 
easily  overcome  interfered  with  his  success.  On  the  fourteenth  of  May, 
1796,  he  made  his  first  experiment,  which  demonstrated  the  possibility  of 
propagating  the  cow-pox  from  one  human  being  to  another.  From  this 
period  till  the  spring  of  1798,  Dr.  Jenuer’s  researches  were  interrupted  by 
the  disappearance  of  the  cow-pox  from  the  dairies.  It  again  showed  itself, 
and  he  had  an  opportunity  of  repeating  his  inquiries.  Before  bringing  out 
his  Inquiry  on  the  Variolce  Vaecince ,  he  was  desirous  of  proving  by  direct 
experiment  the  truth  of  his  opinion  as  to  the  origin  of  cow-pox,  which  at 
that  time  rested  only  on  circumstantial  evidence.  Being  foiled  in  his  hopes 
of  seeing  more  of  that  disease  in  its  usual  form  in  the  dairies,  he  made 
many  efforts,  in  1797,  to  generate  it  from  the  heel  of  the  horse.  In  refer¬ 
ence  to  these  experiments  he  wrote  on  the  second  of  August,  1797,  to  a 
friend  in  the  following  terms  : 

“The  simple  experiment  of  applying  the  matter  from  the  heel  of  the  horse,  in  its 
proper  state,  to  the  nipples  of  the  cows  when  they  are  in  a  proper  state  to  be  infected  by 
it,  is  not  so  easily  made  as  at  first  sight  may  be  imagined.  After  waiting  with  impa¬ 
tience  for  months  in  my  own  neighborhood,  without  effect,  I  sent  a  messenger  to  Bristol 
in  vain  to  procure  the  true  virus.  I  even  procured  a  young  horse,  kept  him  constantly 
in  the  stable,  and  fed  him  with  beans  in  order  to  make  his  heels  swell,  but  to  no  purpose. 
By  the  time  the  pamphlet  goes  to  a  second  edition,  I  hope  to  bo  able  to  give  some  decisive 
experiments.” 

At  the  time  of  the  publication  of  the  “  Inquiry,”  with  regard  to  the 
opinion  that  the  source  of  the  infection  of  cow-pox  “is  a  peculiar  morbid 
matter  arising  from  the  heel  of  the  horse,”  Jenner  believed  that,  though  it 
had  not  been  completely  proved  by  actual  experiments  made  under  his  own 
eye,  ir.  nevertheless  was  supported  by  evidence  sufficiently  strong  to  estab¬ 
lish  it. 

When  the  inquiry  was  presented  he  imagined  that  the  matter  excreted  in 
the  heel  of  the  horse  required  to  be  modified  by  passing  through  the  sys¬ 
tem  of  the  cow,  in  order  to  afford  it  the  peculiar  protecting  power  which  it 

■'Political  Essay  on  the  Kingdom  of  New  Spain,  by  Alexander  De  Humboldt;  London.  1811:  vol.  2,  pp. 


Variolas  Equince  ( Horse  Pox ), 


217 


evinced  when  it  appeared  in  the  shape  of  what  is  vulgarly  called  cow-pox 
on  the  hands  of  the  milkers.  In  the  infancy  of  the  investigation  this  was 
a  most  natural  conclusion ;  but  subsequent  trials  found  that  the  equine 
matter,  which  had  never  undergone  any  change  from  passing  through  the 
constitution  of  the  cow,  exhibits  all  the  characters  of,  and  affords  all  the 
security  which  can  be  obtained  from  vaccine  matter  strictly  so  called. 

The  following  remarks  of  Dr.  Jenner  will  illustrate  this  statement : 

“The  skiu  of  the  horse  is  subject  to  an  eruptive  disease  of  a  vesicular  character,  which 
vesicle  contains  a  limpid  fluid,  showing  itself  most  commonly  in  the  heels.  The  legs  first 
become  ocdematous,  and  then  fissures  are  observed.  The  skin  contiguous  to  these  fissures, 
when  accutely  examined,  is  seen  studded  with  small  vesicles  surrouuded  by  an  areola. 
These  vesicles  contain  the  specific  fluid.” 

“  It  is  the  ill  management  of  the  horse  in  the  stable  that  occasions  the  malady  to  ap¬ 
pear  more  frequently  in  the  heel  than  in  other  parts.  I  have  detected  it  connected  with 
a  sore  on  the  heels  of  the  horse,  and  on  the  thigh  of  a  colt.” 

It  lias  been  established  by  unquestionable  evidence  that  matter  from  the 
horse?  does  produce  a  pustule  similar  in  appearance  to  the  vaccine ;  and 
likewise  possessing  the  same  protective  power;  and  that,  without  having 
passed  through  the  constitution  of  the  cow.  This  fact,  though  it  tends  to 
prove  the  close  relationship,  if  not  the  absolute  identity  of  the  diseases, 
does  not  prove  that  they  both  originated  in  the  horse;  but  it  strongly  con¬ 
firms  the  views  of  the  simultaneous  origin  of  the  affections  in  question. 

It  seems  certain  that  there  are,  at  least,  four  animals,  namely,  the  horse, 
the  sheep  and  the  goat,  which  are  affected  with  a  disorder  communicable 
to  man;  and  capable  of  securing  him  from  what  appears  to  be  a  malignant 
form  of  the  disease.  It  has,  moreover,  been  proved  by  direct  experiment, 
that  other  animals  are  capable  of  receiving  the  vaccine  disease  by  inocula¬ 
tion  ;  and  that  matter  taken  from  pustules  so  produced  affords  the  genuine 
cow-pox  in  man.  These  animals  on  which  these  experiments  have  been 
tried  are  the  dog,  the  goat,  the  she-ass,  and  the  sheep.  The  fact  with  re¬ 
gards  to  the  dog  was  ascertained  by  Dr.  Jenner;  with  respects  to  the  other 
animals,  the  facts  rest  on  the  authority  of  Valentine,  of  Nancy,  who  made 
his  experiments  in  1801-2,  in  communicating  the  human  small-pox  to  dogs, 
asses  and  swine;  he  asserted  also,  that  it  had  been  proved  by  experiments 
at  the  Royal  Veterinary  College  at  Berlin,  that  the  cow  likewise  receives 
the  small-pox  by  inoculation.* 

It  is  perhaps  to  be  regretted  that  Jenner  employed  the  word  grease ,  in¬ 
stead  of  the  Variolce  Equince.  The  grease  has  no  necessary  connection  with 
the  horse-pox  (Variolce  Equince),  though  the  disorders  frequent^7  co-exist. 
This  circumstance  at  first  misled  Dr.  Jenner,  and  caused  much  misappre¬ 
hension  ahd  confusion.  The  mistake  in  considering  the  disease,  vulgarly 
called  the  grease ,  as  the  source  of  the  cow-pox  was  subsequently  corrected 
by  Dr.  Jenner  himself;  and  he  recognized  the  fact  that  the  horse,  as  well 
as  the  cow,  is  liable  to  an  eruptive  disease  of  a  variolous  character,  and 
that  this  disease  of  the  horse,  when  communicated  to  man,  is  capable  of 
affording  protection  against  small  pox,  even  though  it  had  never  passed 
through  the  cow.  For  the  most  part,  however,  the  equine  affection  was 
seldom  recognized  in  the  dairies,  except  in  connection  with  a  similar  dis¬ 
ease  in  the  cow. 

According  to  Dr.  John  Baront,  the  last  observation  of  Dr.  Jenner  on 
the  V ariolse  Equinse  was  in  1817.  Dr.  Baron  copies  the  following  mem¬ 
orandum  from  a  manuscript  written  by  Dr.  Jenner  on  the  first  of  April, 
1817: 


*Meilical  mid  I’liywical  Journal,  September,  1802,  p.  271, 

tThe  Life  of  Edward  Jenner,  M.  1).,  P.  E.  S  ,  etc.  London,  1838.  Vol.  2,  p.  220, 


218 


Variolce  Equince  (Horse  Pox J, 


“Rise  and  progress  of  the  equine  matter  from  the  farm  of  Allen  of  Wan- 
sell — From  a  horse  to  Allen  ;  from  Allen  to  two  or  three*of  the  milch  cows  ; 
from  the  cows  to  James  Cole,  a  young  man  who  milked  at  the  farm ;  from 
James  Cole  to  John  Powell,  by  inoculation  from  a  vesicle  on  the  hand  of 
Cole  ;  and  to  Anne  Powell,  an  infant ;  from  Powell  to  Samuel  Rudder ;  from 
Rudder  to  Sophia  Orpin  and  to  Henry  Martin ;  from  Henry  Martin  to  Eliz¬ 
abeth  Martin.  All  this  went  on  with  perfect  regularity  for  eight  months, 
when  it  became  intermixed  with  other  matter,  so  that  no  journal  was  kept 
afterwards.  Proof  was  obtained  of  the  patients  being  duly  protected.” 

Another  entry  on  the  seventeenth  of  May  runs  thus  :  Took  matter  from 
Jane  King  (equine  direct),  for  the  National  Vaccine  Establishment.  The 
pustule  beautifully  correct.” 

The  matter  from  this  source  is  said  to  have  been  extensively  diffused  in 
England  and  Scotland.  Some  years  before  1817,  Mr.  Melon,  of  Litchfield, 
had  found  the  equine  virus  in  his  neighborhood,  and  sent  a  portion  of  it  to 
Dr.  Jenner. 

In  1818,  Dr.  John  Baron  sent  Dr.  Jenner  some  equine  matter,  which  he 
obtained  from  the  hands  of  a  boy  who  had  been  infected  direct!}7-  from  the 
horse.  In  this  case  the  disease  assumed  a  pustular  form,  and  extended 
over  both  arms. 

Dr,  Jenner  thus  acknowledges  the  reception  of  this  matter : 

“April  25,  1818. 

“Yesterday  H.  Sharpneil  brought  me  the  equine  virus  and  your  drawing,  which  con¬ 
veys  so  good  an  idea  of  the  disease,  that  no  one  who  lias  seen  it  can  doubt  that  the  ves¬ 
icles  contain  the  true  and  genuine  primative  fluid.  I  have  inserted  some  of  it  into  a 
child’s  arm ;  but  I  shall  be  vexed  if  you  and  some  ot  your  young  men  at  the  Infirmary 
have  not  done  the  same  with  the  fluid  fresh  from  the  hand.  *  *  * 

“  With  best  affections,  yours,  my  dear  doctor,  very  truly, 

“EDWARD  JENNER.” 

We  have  thus  given  the  facts  which  referred  to  Dr.  Jenner’s  experi¬ 
ments,  and  conclusions  as  to  the  relations  of  cow-pox  to  the  grease  and 
horse-pox;  it  should  be  noted  that  valuable  observations  were  made  by 
others  upon  this  subject  at  an  early  date  in  the  history  of  vaccination. 

As  early  as  18U0,  Mr.  Tanner,  a  veterinary  surgeon  at  Rockhampton, 
raised  a  perfect  vaccine  vesicle  on  the  teat  of  a  cow,  by  first  removing  a 
scab  from  the  surface  of  an  accidental  sore,  and  then  rubbing  over  the  sore 
the  limped  matter  taken  from  the  heels  of  a  horse  afflicted  with  what  he  re¬ 
garded  as  the  grease.  Lymph  taken  from  the  vesicle  thus  raised  was  success¬ 
fully  transferred  to  the  human  subject,  and  a  stock  of  vaccine  thus  ob¬ 
tained,  some  of  which  was  sent  to  Jenner,  and  through  him  to  the  Small¬ 
pox  Hospital.  [Bing’s  Treatise  on  the  Coiv-pox, p.  336. ) 

Mr.  Lupton,  of  Thame,  m  Oxfordshire,  in  1800,  correctly  pointed  out 
that  the  disease  of  the  horse,  which  was  analogous  to  cow-pox,  and  was 
communicable  to  the  cow,  was  not  “  the  grease ,”  nor  any  form  of  grease, 
but  a  disease,  regarded  by  the  farmers  of  the  neighborhood,  as  widely  dif¬ 
ferent  from  it,  and  to  which  they  gave  the  name  of  the  “  scratchy  heel,” 
Medical  and  Physical  Journal ,  vol.  4,  November,  1800. ) 

In  1801,  Loy,  after  many  unsuccessful  attempts,  succeeded  in  infecting  four 
cows,  by  inoculation  with  lymph  from  a  “  greasey  ”  horse  which  with  con¬ 
siderable  indisposition  had  a  generalized  eruption. 

Loy  observed  that  the  horses  “  that  did  not  communicate  the  disease  had 
a  local  affection  only.” 

He  was  led  by  his  experiments  to  distinguished  two  forms  of  grease,  the 
acute  and  the  chronic,  the  former  of  which  alone  he  regarded  as  capable  of 
imparting  the  cow-pox  to  the  cow  or  to  man,  and  then  only  when  the  mat¬ 
ter  was  taken  at  the  proper  period  of  the  vesicle.  ( Loy ,  Experiments  on  the 
Origin  of  the  Cow-pox,  vol.  8,  Whitley,  1801 J 


Variolce  E quince  ( Horse  Pox ). 


219 


In  1803,  Dr.  La  Font,  a  French  physician  at  Salonica,  was  successful  in 
producing  the  perfect  vaccine  vesicle  in  two  young  children  with  lymph, 
taken  direct  from  a  horse  suffering  from  a  disease  which  was  known  to  the 
Macedonian  farmers  as  u grease  ,”  but  which  they  distinguished  from  ordi¬ 
nary  grease  by  the  epithet,  “  the  variolous.”  The  preservation  of  this  fact 
was  due  to  the  great  and  zealous  advocate  of  vacciuation,  Dr.  De  Carro. 

DR.  De  CARRO  TO  DR.  JENNER. 

Vienna,  June  21,  1803. 

My  Dear  Sir — My  friend,  Dr.  Marcet,  wrote  to  me  lately  that  the  account  I  have  sent 
you  of  Dr.  Sacco’s  experiments  have  afforded  you  great  satisfaction.  The  motive  which 
induces  me  to  write  to  j'ou  to-day  is  another  confirmation  of  your  theory,  which  has 
taken  place  in  a  country  where  you  scarcely  expect  it  from,  the  more  so  that  it  is  accom¬ 
panied  with  veterinary  observations  which  appear  to  me  very  nice  and  curious. 

Monsieur  La  Font,  a  French  physician  established  at  Salonica,  in  Macedonia,  has  been 
one  of  the  most  active  vaccinators  I  know  on  the  Continent ;  his  last  letter,  of  the  third 
of  June,  mentions  that  he  has  since  last  autumn  vaccinated  1130  persons.  He  first  heard 
of  your  discovery  on  the  occasion  of  Lord  Elgin  traveling  in  Greece  with  Dr.  Scott,  dur¬ 
ing  which  journey  his  lordship  and  the  doctor  took  a  particular  care  of  propagating 
vaccination.  The  English  Consul  at  Salonica  went  to  Athens  to  meet  Lord  Elgin  ;  there 
he  saw  a  large  number  of  young  Athenians  with  vaccine  pustules.  Not  a  word  had  yet 
been  heard  at  Salonica  of  your  discovery,  and  he  desired  Dr.  Scott  to  give  him  vaccine 
matter  to  put  into  the  hands  of  Dr.  La  Font,  and  Lady  Elgin  was  so  kind  as  to  give  to 
the  Consul  a  copy  of  my  work  for  the  instruction  of  his  physician.  The  first  Athenian 
matter  did  not  succeed,  but  seeing  its  failure  Dr.  La  Font  applied  directly  to  me,  and 
my  ivory  lancets  produced  their  effect  at  the  first  trial.  Since  that  time  I  have  been  in 
regular  correspondence  with  that  physician,  who  appears  to  me  to  be  possessed  of  much 
learning,  prudence  and  activity. 

Some  time  afterwards  I  sent  him  a  translation  of  Dr.  Loy’s  experiments,  and  desired 
him  to  make  as  mauy  veterinary  observations  and  experiments  as  he  could.  He  has  some 
reasons  to  suppose  that  the  cow-pox  reigns  in  that  country,  according  to  the  reports  of 
several  Albanian  peasants.  As  to  the*  (/reuse  (which  he  calls  javart),  he  says  that  the 
farmers  at  Salonica  know  it  well.  Dr.  La  Font  began  his  experiments  with  the  kind  of 
grease  which  the  Macedonian  farriers  call  variolous.  He  found  a  horse  which  had  been 
attacked  with  feverish  symptoms,  that  ceased  as  soon  as  the  eruption  appeared.  The 
fore  legs  were  much  swelled  ;  the  left  had  four  ulcers,  one  upon  the  heel,  a  second  some 
inches  higher,  a  third  on  the  articulation,  a  fourth  near  the  breast.  The  eruption  on  the 
legs  was,  he  says,  very  like  the  small-pox,  but  none  was  to  be  seen  on  the  other  parts  of 
the  body.  He  took  matter  from  the  upper  ulcer  which  was  of  twelve  days  standing. 

The  matter  was  limpid,  but  a  Itttle  yellowish  and  filamentous  (three  only);  first,  a  cow 
was  submitted  to  this  inoculation,  but  without  success  ;  secondly,  a  girl  twelve  years  old, 
without  effect;  but  this  girl  had  been  vaccinated  some  months  before  without  success, 
and  was  suspected  to  have  had  the  small-pox  ;  thirdly,  two  boys,  one  six,  the  other  five 
years  old,  wrere  inoculated  with  the  same  equine  matter,  and  in  both  a  pustule  appeared, 
which  followed  the  regular  course  of  a  vaccine  pustule.  The  color  was  less  white  and 
more  purple  than  usual.  These  two  children  had  a  pretty  strong  fever,  for  which  some 
cooling  medicines  were  administered.  Those  inoculated  with  matter  from  them  under¬ 
went  the  disease  in  the  usual  mild  way. 

These  particulars,  I  hope,  will  silence  all  those  who  still  doubt  of  the  method  of  your 
doctrine.  These  observations  enhance  the  merits  of  your  discovery.  The  means  of  mak¬ 
ing  it  were  everywhere,  yet  nobody  before  you  had  the  least  idea,  of  that  singular  con¬ 
nection  between  the  grease,  the  cow-pox  and  the  small-pox.”  (Life  of  Edward  Jenner  by 
■John  Baron  ;  vol.  1,  p.  431.) 

Coleman,  whose  early  attempts  had  failed,  at  a  subsequent  period  suc¬ 
ceeded  in  infecting  a  cow  with  matter  taken  direct  from  the  heels  of  a 
horse,  and  in  propagating  vaccine  from  the  vesicles  thus  induced. 

Direct  inoculations  were  made  by  Yiborg  and  by  Kahlert  on  cows,  and  by 
Steinbeck,  both  on  cows  and  children  ;  and  Sacco  and  several  others  suc¬ 
ceeded  in  producing  on  human  subjects  perfect  vaccine  vesicles  with  lymph 
taken  from  sores  (vesicles)  on  the  hands  of  individuals,  which  sores  they 
were  quite  satisfied  had  been  derived  from  the  horse. 

In  France,  from  the  general  negative  results  of  repeated  inoculations 
from  horses’  heels,  doubts  of  the  existence  of  an  equine-pox  seemed  to 
have  been  largely  entertained  up  to  a  very  recent  period;  and  Bosquet,  re 


Artificial  Production  of  Horse- Pox. 


viewing,  in  1848,  the  whole  of  the  experiments  and  observations  up  to  that 
time,  declared  himself  unsatisfied  as  to  whether  cow-pox  had  ever  been  de¬ 
rived  from  the  horse  or  not.  ( Nouveau  TraiU  de  la  Vaccine ,  p.  436. ) 

But  within  the  last  twentv-tliree  years,  the  doubts  of  this  connection 
of  variolse  vaccina}  with  vanolae  equinse,  have  been  set  at  rest  amongst  the 
French  physicians. 

Two  outbreaks  of  the  disease  among  horses — one  near  Toulouse  in  1860, 
and  one  at  Alfort,  in  1863 — gave  rise  to  inoculations,  the  results  of  which 
were  acknowledged  to  be  entirely  unequivocal.  These  outbreaks  were  care¬ 
fully  observed  and  the  phenomena  of  liorse-pox  well  described. 

M.  Bresley,  in  1863,  induced  the  horse  pox,  by  inoculation  in  the  horse 
and  other  animals — the  equine  lymph  being  transferred  from  horse  to  horse. 

Dr.  Edward  0.  Seaton  has  given  the  following  observations  upon  the 
horse-pox  in  his  valuable  u  Handbook  of  Vaccination,”  which  we  have 
classified  and  condensed: 


ARTIFICIAL  PRODUCTION  OF  HORSE-POX  BY  INOCULATION. 

The  horse-pox  has  been  designedly  induced  in  the  horse  and  other  ani¬ 
mals  of  the  horse  tribe  by  inoculation;  (a)  with  equine  lymph  directly 
transferred  from  horse  to  horse ;  this  was  done  on  numerous  occasions,  and 
with  great  success,  in  1863,  by  M.  Bonley  (Bulletin  de  PAcadeinie,  tome 
29,  p.  236)  (b )  with  equine  lymph  that  had  been  passed  successfully  through 
a  cow,  producing  in  that  animal  all  of  the  phenomenon  of  the  genuine  in¬ 
oculated  cow-pox;  this  was  done  both  in  1860  at  Toulouse  by  M.  Lafosse 
(Rapport  de  PAcadeinie  Imperials  de  Medeeine  sur  les  Vaccinations  pen¬ 
dant  PAnnee,  1861),  and  in  1863  at  Alfort  by  M.  Bonley,  and  at  the  Jardin 
d’ Acclimatisation  at  Paris  (Bulletin  de  PAcademie,  tome  29,  pp.  131,  133 
and  199);  (cj  with  lymph,  supposed  to  be  unhumanized  cow-lymph,  not  pri¬ 
mary,  but  the  product  of  a  series  of  transmissions  of  primary  lymph 
through  animals  of  the  ox  tribe ;  this  was  done  by  M.  Chauveau  and  his  col¬ 
leagues  (Vaccine  et  Varioloe,  etc.,  of  Cit, )  ;  and  (d)  with  ordinary  human 
ized  vaccine  lymph;  an  experiment  thus  made,  in  1862,  by  MM.  Rayer  and 
De  Paul,  at  Alfort,  resulted  in  the  production  of  eight  well-characterized 
vesicles,  perfectly  circular,  with  central  depression  and  induration  of  the 
whole  surrounding  thickness  of  the  dermis. 

In  the  horse-pox  induced  by  the  ordinary  process  of  inoculation,  erup¬ 
tion  is  limited,  with  rare,  if  any,  exceptions,  to  the  points  of  inoculation. 
The  local  phenomenon  are  less  active  than  in  the  natural  disease,  but  the 
course  of  the  disease  is  essentially  the  same. 


ARTIFICIAL  PRODUCTION  OF  HORSE-POX  BY  INJECTION  OF 

LYMPH. 

A  variety  of  inoculation,  viz.,  that  of  injecting  the  liquid  vaccine  lymph 
into  the  blood  vessels  or  lymphatics  of  horses  has  been  attempted  by  M. 
Chauveau,  with  the  design  of  producing,  if  possible,  by  this  method,  the 
more  extended  or  generalized  eruption,  which  in  this  tribe  of  animals  fre¬ 
quently  attends  the  natural,  or,  as  it  is  called,  spontaneous  disease. 

M.  Chauveau  inoculated  from  old  horses  by  injecting  some  vaccine  lymph 
into  a  blood  vessel,  and  four  more  by  injecting  into  a  lymphatic  vessel,  just 
before  its  entrance  into  a  ganglion.  The  first  series  of  experiments  failed  ; 
but  of  the  animals  in  the  second  series  (those  inoculated  through  the 
lymphatics)  the  inoculation  succeeded  in  three  out  of  the  four,  producing  a 
fine  eruption  of  vaccine,  which  had  all  the  characters  of  the  spontaneous 


Character  and  Course  of  Horse-Pox 


221 


horse  pox.  One,  a  horse,  had  a  full  eruption,  commencing  at  the  end  of 
eleven  days,  and  completely  developed  in  three  or  four  days  more,  on  the 
nostrils  and  lips,  as  well  as  on  the  hind  heels;  the  second,  a  mare,  infected 
from  the  preceding,  had  isolated  vesicles  disseminated  over  the  body,  ex¬ 
cept  the  neck  and  posteriors,  but  chiefly  in  the  mammary  region  and  on  the 
lips,  the  eruption  commencing  on  the  eighth  day,  and  continuing  to  appear 
up  to  the  fourteenth ;  and  the  third,  a  man,  had,  on  the  twelfth  day,  an 
eruption  chiefly  on  the  genital  organs  and  the  inner  surface  of  the  thighs. 
Seed  virus,  taken  from  the  eruption  on  each  of  these  animals,  produced,  it 
is  said,  regular  vaccine  both  on  the  cow  and  on  children.  Subsequently 
M.  Chauveau  succeeded  in  inoculating  a  young  colt  by  two  injections  of 
vaccine  lymph,  at  intervals  of  two  days,  direct  into  the  sanguinenous  system 
through  the  jugular  vein  ;  vesicles  beginning  to  appear,  principally  in  the 
naso-labial  region,  in  twelve  days,  and  continuing  to  appear  for  four 
days  more,  the  lymph  of  which  was  found  to  produce  regular  vaccine  both 
on  a  child  and  on  animals  of  the  ox  tribe. 

Following  out  still  further  the  same  idea,  M.  Chauveau,  by  injecting  vac¬ 
cine  into  a  pouch  formed  in  the  subcutaneous  cellular  tissue  on  the  left  side 
of  the  neck  of  a  colt,  but  with  great  care  that  the  lymph  should  not  touch 
the  wounded  skin,  obtained  no  local  vesicle,  but  an  eruption,  commencing 
on  the  tenth  day,  of  a  few  vesicles  on  the  naso  labial  region.  From  these 
results,  in  connection  with  the  fact  that  nearly  thirty  successful  inocula¬ 
tions  of  horses  with  the  vaccine  lymph  in  the  ordinary  way,  no  general 
eruption  followed,  M.  Chauveau  concludes  that  one  essential  condition  of  a 
generalized  eruption  to  be  that  the  virus  should  not  pass  through  the  mem¬ 
brane  which  is  the  anatomical  seat  of  the  vaccine  eruption. 

M.  Le  Blanc, ^however,  states  that  he  has  seen  general  eruption  to  occur 
in  a  case  in  which  inoculation  had  been  done  in  the  ordinary  way,  and  that 
he  proved  the  vaccinal  character  of  the  vesicles  secondarily  developed  by 
equinating  successfully  from  them,  both  horses  and  ruminants.  (Chauveau, 
Des Conditionsqui president au  Developpement de laYaccine dite Primitive; 
Bulletin  de  PAcad.  Imp.  de  Med. ;  tome  31  ;  also,  Comptes  Rendus  de  P  Acad, 
des  Sciences,  tome  62,  p.  1118,  and  tome  63,  p.  573.) — A  Hand-Book  of  Vac¬ 
cination ,  by  Edward  C.  Seaton ,  M.  I).,  Medical  Inspector  of  the  Privy  Council , 
pp.  29-33. 


-  CHARACTER  AND  COURSE  OF  HORSE  POX. 

It  is  evident  from  the  preceding  facts,  that  the  Horse,  like  the  Cow,  is 
subject  to  a  specific  eruptive  fever,  resulting  in  the  development  of  a  pock, 
the  material  of  which  has  the  same  property  as  the  fluid  of  cow-pox,  pro¬ 
tecting  the  human  system,  when  inoculated  with  it,  from  small-pox.  This 
pock  has  the  outward  appearance  and  the  anatomical  structure  which  dis¬ 
tinguish  the  vesicles  of  cow-pox.  The  chief  point  in  which  the  diseases  as 
seen  in  the  horse,  differ  from  that  in  the  cow  are,  (1)  the  locality  of  the 
eruption — which  is  chiefly  on  the  heels,  and  on  the  naso  labial  mucous 
membrane;  (2)  the  tendency  of  the  eruption  in  some  cases  to  become  gen¬ 
eralized  over  the  body;  and  (3)  its  appearance  in  the  male  as  well  as  in 
the  female,  horses  being  subject  to  it  as  well  as  mares. 

The  disease  differs  so  little  in  its  course  from  the  cow-pox  in  the  cow, 
that  very  minute  description  is  not  necessary.  The  chief  distinction  is  as 
to  the  part  of  the  body  affected,  which  in  the  horse  is  principally  the  hind 
legs ;  the  eruption  being  generally  more  copious  there  than  anywhere 
else,  and  seldom  extending  beyond  the  hocks,  except  as  the  result  of  auto- 
inoculation.  It  is,  no  doubt,  from  its  great  exposure  to  this  kind  of  inocu- 


222 


Natural  History  of  Cow-Pox. 


lation  that,  after  the  heels,  the  naso -labial  mucous  membrane  is  the  chief 
seat  of  eruption.  In  some  cases  the  vesicles  seen  in  this  membrane  maybe 
primary  ;  and  there  are  said  to  have  been  cases  in  which  this  membrane 
was  the  sole  seat  of  the  disease.  Occassionally,  especially  in  certain  epi¬ 
zootics,  the  eruption  has  been  seen  extending  over  the  body,  in  greater  or 
less  abundance,  from  the  heels  to  the  belly,  and  from  the  head  to  the  tail. 
This  general  eruption,  when  it  occurs,  may  come  on  in  the  course  of  the 
disease,  and  after  the  usual  local  symptoms  have  manifested  themselves ; 
or  the  generalization  may  be  noticed  from  the  very  outset. 

The  course  of  the  disease  is  this  :  There  is  a  period  of  invasion,  some¬ 
times  accompanied  with  fever,  which,  if  it  occur  at  all,  is,  in  the  great  ma¬ 
jority  of  instances,  very  trifling ;  then,  on  the  posteriors  and  other  parts 
about  to  develop  the  eruption,  points  are  felt,  or  seen,  which  soon  acquire 
prominence  and  take  the  form  of  pimples,  becoming  rapidly  flattened  and 
umbilicated  at  the  centre.  These,  by  the  eighth  or  ninth  day,  are  fully  de¬ 
veloped,  mostly  circular,  and  of  the  size  of  a  big  lentil,  notably  elevated 
above  the  skin,  resisting  pressure,  and  having  a  well-marked  surrounding 
induration.  They  have  absolutely  the  same  structure  as  the  vaccine  or  va¬ 
riolous  vesicle,  and  yield,  although  generally  in  small  quantity,  a  viscid, 
slightly  yellowish  lymph.  By  the  ninth,  tenth,  or  eleventh  day  many  of 
them  burst,  exuding,  often  copiously,  a  viscid,  serous,  or  sero-purulent  fluid  ; 
incrustation  going  on  progressively  and  forming  scabs  or  crusts,  which, 
from  the  fifteenth  to  the  twenty-fifth  day,  detach  themselves,  leaving 
whitish  superficial  vesicles.  Varieties  arc  observed,  as  in  cow-pox,  some 
of  the  vesicles  being  smaller  and  later  than  others,  some  less  markedly 
umbilicated,  some  not  umbilicated  at  all.  They  are  most  developed  on  the 
parts  that  are  naked  or  have  little  hair,  or  where  the  skin  is  fine.  If  the 
hair  be  long  and  close,  they  are  smaller  and  less  regular,  and  attentive  ob¬ 
servation  is  often  necessary  to  make  out  their  existence;  little  pencils  of 
hair  will  be  seen  standing  up  here  and  there,  and  if  the  finger  be  lightly 
moved  over  these  spots,  slight  indurations  will  be  felt,  corresponding  to 
pimples  or  vesicles,  which  may  be  brought  to  light  by  cutting  the  hair 
away.  The  horse-pox,  like  the  cow-pox,  is  communicated  from  animal  to 
animal  by  casual  inoculations,  immediate  or  mediate,  and  these  inocula¬ 
tions  are  the  main  cause  of  the  spread  of  the  disease. 

Horse-pox  should  be  distinguished  from  grease  on  the  one  hand  and 
Aphtha  epizotica  on  the  other. — A  Hand- Booh  of  Vaccination,  by  Edward 
C.  Seaton ,  M.  JD.,  Medical  Inspector  of  the  Privy  Council ,  pp.  27-20. 

GENERAL  DESCRIPTION  OF  COW-POX— OBSERVATIONS  ON 
COW-POX  BY  ROBERT  CEELY— ILLUSTRATION  OF  THE 
APPEARANCE  OF  THE  HABITUAL  COW-POX. 

The  cow-pox  was  thoroughly  investigated  by  Edward  Jenner,  and  he  is 
also  said  to  have  exhibited  drawings  of  the  appearance  of  the  disease  in 
the  cow. 

The  natural  history  of  vaccinia  in  the  cow  has  been  studied  more  or  less 
by  various  other  observers,  but  by  none  so  accurately  or  so  comprehen¬ 
sively  as  by  Robert  Ceely,  of  Aylesbury,  who,  in  1839,  showed  in  a  satis¬ 
factory  manner  that  by  operating  upon  the  mucous  surfaces,  instead  of  the 
more  insensible  corion,  the  cow  can  be  made  with  facility  to  receive  the 
variolous  poison,  which  the  constitution  of  that  animal  converts  into  vac¬ 
cine.  These  important  experiments  were  instituted  under  the  auspices  and 
supervision  of  the  Provincial  Medical  and  Surgical  Association,  in  whose 
transactions  (vols.  8  and  9)  they  are  detailed  at  great  length. 


COW  POX. 


PLATE  19 


Fig.  80.'  The  Casual  Cow-Pox  in  the  teats  and 
udder  of  a  black  and  zvhite  milch  cow.  After 
Mr.  Ceely ,  of  Aylesbury. 


TMtNEW  ORLEANS  UTH.C?tO  UNIONST. 


223 


Natural  History  of  Cow-Pox. 


To  facilitate  the  labors  of  the  medical  profession  with  reference  to  the 
recognition  and  propagation  of  the  cow-pox,  we  have  reproduced  the 
accompanying  plate  of  the  vaccine  disease,  as  it  appears  in  the  cow,  from 
the  illustrations  of  this  affection  by  Mr.  Ceely,  of  Aylesbury,  England. 

The  plate  illustrates  the  appearance  of  the  casual  cow-pox  in  the  teats 
and  udder  of  a  black  and  white  milch  cow.  Plate  19,  Figure  80. 

The  disease  is  at  its  acme  ;  and  the  skin  being  fair  a  slight  areola  is 
visible  around  some  of  the  vesicles,  many  of  which  have  a  bluish  central 
tint.  It  exhibits  papular  vesicles  with  central  crusts,  unacuminated  and 
acuminated  vesicles ;  imperfectly  developed  and  also  broken  vesicles,  both 
solitary  and  interfluent.  The  vesicles  on  the  extremities  of  the  teats  are 
nearly  of  the  color  of  the  skin  on  which  they  are  placed,  a  circumstance  of 
itself  sufficient  to  distinguish  them  from  spurious  or  sub-epidemic  vesicles. 


GENERAL  DESCRIPTION  OF  COW-POX— COURSE  OF  LOCAL 
PHENOMENA— DURATION  OF  THE  VARIOUS  STAGES  OF 
COW-POX— CONSTITUTIONAL  SYMPTOMS— SPURIOUS  COW 
POX— DIAGNOSIS  OF  TRUE  COW-POX. 

Cow-pox  is  a  specific  eruptive  disease,  of  the  vesicular  order,  the  erup¬ 
tion  not  being  general  over  the  body,  but  limited,  to  the  udder  and  teats  of 
the  cow,  the  only  exceptions  being  the  results  of  accidental  or  casual  in¬ 
oculation.  Cow-pox  is  met  with  from  time  to  time,  in  various  countries, 
either  sporadically  or  as  an  epizootic,  attacking  particularly  milch  cows  ; 
young  cows  and  milch  heifers  appearing  to  be  more  subject  to  it  than  older 
cows.  In  its  earlier  stages  it  is  attended  with  so  little  general  or  obvious 
local  disturbance  that,  in  the  animals  first  attacked  in  a  dairy,  these  stages 
seldom  come  under  skilled  observation ;  and,  as  the  fluid  of  the  vesicles  is 
very  infective,  and  the  disease  is  thus  readily  conveyed  from  animal  to  ani¬ 
mal  by  the  milkers,  it  is  difficult  to  distinguish,  in  animals  subsequently 
attacked,  between  those  exhibiting  the  natural  disease  and  those  who  have 
been  infected  casually  by  inoculation.  There  is  first  a  period  of  incuba¬ 
tion  5  but,  from  the  extreme  slightness  of  the  earliest  symptoms,  it  is  very 
difficult  to  say  how  soon  after  infection  has  been  received  these  may  mani¬ 
fest  themselves.  In  the  natural  disease  the  incubative  period  is  probably 
three  or  four  days,  though  in  some  cases  it  may  be  prolonged  to  from  five 
to  eight  .days.  The  earliest  symptoms  noted  are  heat,  swelling  and  tender¬ 
ness  of  the  udder,  soon  followed  by  irregularity  of  surface  and  develop¬ 
ment  of  hard  papules,  about  the  size  of  a  vetch  or  pea,  especially  on  that 
part  of  the  udder  which  adjoins  the  basis  of  the  teats,  and  on  the  basis  of 
the  teats  themselves.  There  is  not  generally  at  this  stage,  any  loss  of 
appetite,  manifestation  of  fever,  or  other  sign  of  constitutional  disturb¬ 
ance.  In  the  casual  disease,  or  that  which  arises  from  infection  by  the  un¬ 
intentional  inoculation  of  the  milkers,  it  is  very  rare  for  any  indications  of 
contagion  to  manifest  themselves  till  the  sixth  or  seventh,  sometimes  they 
do  not  appear  till  the  eighth  or  ninth  day  after  undoubted  exposure ;  but 
in  thin-skinned  animals  with  cracks  or  chaps  in  the  teats,  small  red  tender 
papules  may  often  be  found  by  vigilant  observation  as  early  as  the  filth 
day.  The  papules  increase  in  size  as  the  disease  goes  on,  and  in  three  or 
four  days  from  their  first  appearance,  many  of  them  will  be  found  to  have 
acquired  a  distinct  vesicular  character,  with  more  or  less  central  depression. 
The  first  change  from  papule  to  vesicle  is  indicated  by  the  appearance  of  a 
dull  or  dusty  yellowish  point  at  the  apex  of  the  pimple,  the  circumference 
then  increases  in  substance  and  extent,  and  the  centre  becomes  wider  and 


224 


Natural  History  of  Cow-Pox. 


deeper,  till  at  last  the  flattened  vesicle  with  depressed  centre  is  formed  As 
with  the  papules,  so  with  the  vesicles,  there  is  gradual  increase  of  size, 
until  in  three  01;  four  days  more  their  full  development  is  attained,  the 
number,  size,  shape  and  color  of  the  vesicles,  differ  much  in  different  ani¬ 
mals,  as  well  as  in  different  parts  of  the  same  animal. 

There  may  be  only  one  or  two  of  them,  but  much  more  frequently  there 
are  ten,  twenty  or  more  ;  they  are  more  common  on  the  base,  neck  and 
body  of  the  teats.  The  amount  of  eruption,  and  consequently  the  severity 
of  the  disease,  depends  greatly  on  the  state  of  the  teats  and  udder.  With 
a  short,  compact,  hairy  udder,  and  thick,  smooth,  terse,  unchapped,  or 
scarcely  cracked  teats,  the  affection  is  often  very  mild,  and  sometimes  there 
is  July  a  single  vesicle.  An  animal  with  a  voluminous,  dabby,  cracked, 
pendulous  udder,  and  loose,  long  teats,  the  skin  of  which  is  thin,  dssured, 
rough  and  unequal,  scarcely  ever  escapes  a  copious  eruption.  The  size  of 
the  vesicles  varies  from  that  of  a  large  pin  head  to  that  of  a  sixpence,  or 
bigger,  but  is  most  ordinarily  that  of  a  vetch,  pea,  or  horse-bean ;  in  gen¬ 
eral,  the  more  numerous  the  vesicles  are,  the  smaller  they  are.  Their 
shape  is  determined  chiedy  b}r  their  position.  Around  the  base  or  neck  of 
the  teats  they  are  almost  invariably  circular ;  on  the  body  of  the  teats, 
generally  ovai,  but  oval  vesicles  may  be  seen  also  on  the  udder  ;  and  the 
vesicles  011  the  teats  are  often  interduent.  The  color  of  the  vesiqles  varies 
according  to  the  period  of  their  progress,  and  according  to  the  color  and 
texture  of  the  animal’s  skin ;  but  they  have  always  a  metallic-glistening 
aspect.  JBy  the  time  that  the  vesicle  is  completely  formed,  it  is  frequently 
seven  or  eight  lines  wide;  but  a  solid,  uniform,  terse,  and  shining  margin, 
a  glistening  white,  pinky,  or  silvery  hue,  and  a  bluish  or  slate-colored 
centre;  it  contains  a  clear,  viscid  lymph,  which,  however,  is  even  at  this 
period  generally  in  small  quantity  and  often  difficult  to  obtain;  and  around 
its  base  there  is  a  narrow,  pale-rose,  or  light-damask  areola,  not  more  than 
a  line  or  two  wide,  and  sometimes  scarcely  so  much,  though  subsequently 
extending  witli  circumscribed  induration  of  the  adjacent  skin  and  subjacent 
connective  tissue.  The  color  of  the  areola,  like  that  of  the  vesicles,  is 
greatly  influenced  by  the  hue  and  texture  of  the  skin,  and  in  some  skins — 
as  in  dark,  thick  ones — the  areola  is  scarcely  to  be  seen,  or  is  entirely  ab¬ 
sent;  but  the  induration  is  always  palpable.  Between  the  tenth  and  elev¬ 
enth  days  the  disease  has  generally  reached  its  acme;  the  areola  has  ex 
tended,  though  seldom  to  more  than  a  width  of  from  four  to  live  lines,  and 
there  is  deep  induration  of  the  underlying  integument.  The  vesicles,  such 
as  have  not  been  broken,  are  at  their  fullest  development;  lymph,  which 
two  days  before  was  hard  to  get  from  them,  is  now  so  copious  that  it  raises 
the  cuticle,  destroying  the  central  depression  and  forming  a  globular  or 
conoidal  vesicle,  or  it  bursts  the  cuticle  and  liows/reely  out;  it  has  already 
acquired,  or  soon  acquires,  a  pale,  straw-colored,  or  light-amber  hue,  and 
speedily  becomes  mere  scum,  turbid  and  opaque.  While  this  is  taking 
place  in  some  vesicles,  in  others  the  process  of  incrustation  will  already 
have  begun  at  the  centre,  and  in  others  it  may  have  even  extended  to  the 
circumference.  On  and  after  the  twelfth  day  nearly  all  is  passive;  the  in- 
incrustation  process  continues  steadily  to  advance,  and  by  the  thirteenth 
or  fourteenth  day  the  crusts  have  usually  acquired  their  greatest  magni¬ 
tude,  are  of  a  brownish-black  color,  adhering  more  or  less  tenaciously  to 
the  epidermis  or  skin  beneath,  the  marginal  induration  and  intumescence 
at  the  same  time  subsiding.  The  crusts  after  this  go  on  drying  and  shrink¬ 
ing,  and  they  fall  off  usually  from  the  twentieth  to  the  twenty-third  day, 
by  which  time  the  induration  has  nearly,  but  seldom  wholly,  disappeared. 
The  cicatrices  left  after  the  falling  of  the  crusts  are  shallow,  smooth ,  oval 


Natural  History  of  Cow-Pox. 


225 


or  circular,  and  of  pale-rose,  white  or  whitish  color,  according  to  the  con¬ 
trast  of  the  surrounding  pigment.  The  vesicles  on  the  teats  are  attended 
generally  with  less  areola  and  less  induration  of  circumference  than  those 
on  the  udders,  but  in  other  respects,  in  so  far  as  they  are  undisturbed,  and 
out  of  the  way  of  the  milkers,  they  exhibit  exactly  the  same  phenomenon 
and  undergo  precisely  similar  changes. 

Such  is  the  course  of  the  undisturbed  eruption,  but  from  the  tractions  of 
the  milkers  it  seldom  happens  that  the  vesicles,  where  they  are  most  num¬ 
erous,  as  on  the  base,  neck  and  bodies  of  the  teats,  escape  disturbance.  By 
the  eighth  or  ninth  day,  when  the  uninjured  vesicles  are  the  most  perfect, 
injured  ones  will  be  found  exuding  lymph  from  their  centres,  the  cuticle 
being  loose  or  partially  detached.  Raw  surfaces,  and  brown  and  black 
crusts  will  be  intermingled,  and  here  and  there  will  be  seen  a  conoidal 
vesicle,  often  with  slightly  depressed  apex,  distended  with  pellucid  lymph. 
Two  or  three  days  later  the  appearance  on  the  teats  will  exhibit  crusts, 
large,  black  and  solid,  often  more  than  an  inch  or  two  in  length,  some  firmly 
adherent  to  a  raw  and  elevated  base,  others  partially  detached  from  a  raw, 
red  and  bleeding  surface;  many  florid  red,  ulcerated  surfaces  secreting  pus 
and  exuding  blood ;  the  teats  excessively  tender,  hot  and  swollen,  not  un- 
frequently  one  or  more  forming  a  tumid  mass  of  black  crusts  and  naked 
red  sores,  the  discharge  from  which  imparts  to  the  finger  an  odor  very 
closely  resembling  that  of  the  last  stage  of  small-pox.  In  some  animals 
this  state  will  continue  for  a  week  or  two,  but  in  others  the  process  of  heal¬ 
ing  will  go  regularly  on,  crusts  being  continually  formed  and  renewed,  till 
at  last  they  fall  oft'  and  leave  cicatrices  general^  regular,  smooth,  circular 
or  oval,  but  occasionally  deep  and  irregular. 

With  reference  to  the  duration  of  the  various  stages  of  cow-pox ,  it  appears 
that  the  normal  course  of  the  disease  occupies  from  twenty  to  twenty-three 
days,  which  may  be  divided  into  four  stages,  namely : 

(a)  About  four  days  of  early  symptoms,  during  which  papulation  takes 
place. 

(b )  Six  or  seven  days  to  the  full  development  and  perfect  maturation  of 
the  vesicle. 

fe)  Five  or  six  of  decline  of  the  vesicle  and  formation  of  the  crusts. 

(d)  Five  or  six  more  from  the  completion  of  incrustation  to  the  sponta¬ 
neous  separation  of  the  crusts. 

Stages  (a)  and  (b)  are  often  materially  abridged  in  the  natural  disease, 
while  in  the  casual  disease  (a)  is  sometimes  prolonged,  (b)  being  propor¬ 
tionately  abridged  or  (a)  is  prolonged,  (b)  and  all  subsequent  stages  occu¬ 
pying  the  normal  duration.  These  variations,  however,  in  the  early  stages 
of  the  disease  are  otten  more  supposed  than  real,  the  earliest  symptoms 
being  so  extremely  slight  in  many  cases  that  they  are  overlooked.  Both 
in  the  natural  and  casual  cow-pox  (c)  is  sometimes  prolonged,  often 
abridged.  The  whole  of  the  cow-pox  eruption  is  not  by  any  means  always 
simultaneously  developed.  Papules,  depressed  vesicles,  acuminated  or 
globular  vesicles,  and  vesicles  more  or  less  desiccated,  ranging  in  size  from 
a  pin’s  head  to  a  diameter  of  eight  or  ten  lines,  may  be  seen  on  the  same 
subject  at  the  same  time ;  but  all,  whatever  their  date  of  appearance,  ter¬ 
minating  together.  No  doubt  these  apparent  anomalies  are  due  either  to 
self- vaccination  of  the  cow  from  pressure,  as  in  the  act  of  lying  down,  or 
still  more  frequently  to  the  manipulation  of  the  milker. 

Structure  of  the  Goiv-pox  Vesicle. — If  we  examine  the  anatomical  struc¬ 
ture  of  the  cow-pox  vesicle,  when  completely  formed,  we  find  it  consist  of 
a  number  of  cells,  which  ax>pear  to  be  arranged  in  two  concentric  rows, 
and  are  separated  from  each  other  by  whitish  radiating  partitions  united 


226 


Natural  History  of  Cotv-Pox. 


at  their  converging  extremeties  by  a  central  membraneous  band.  In  these 
cells  is  secreted  and  contained  a  clear  viscid  lymph.  The  dusky  central 
spot,  which  marked  the  first  change  of  the  pimple  into  the  vesicle,  and 
which  has  now  become  darker  and  more  distinct,  seems  to  be  caused  by  a 
greater  or  less  degree  of  separation  of  the  epidemics  stretched  over  a 
crypt-like  recess,  which  contains  a  small  quantity  of  semi-concrete  lymyh- 
like  matter  and  occassionally  a  turbid  opaque  fluid.  This  cellular  con¬ 
formation  of  the  vesicle  is  essential  and  diagnostic.  It  is  by  the  bursting 
and  breaking  up  of  the  cells  and  their  connecting  band,  as  the  lymph  be¬ 
comes  more  abundant  and  less  viscid,  and  by  separation  of  the  epidermis 
from  its  attachment  to  the  subjacent  adventitious  membrane,  that  the 
vesicle  in  ]ts  further  progress  loses  its  distinctive  central  depression,  and 
acquires  the  acuminate  or  con vidal  form,  which  has  been  described. 

Constitutional  Symptoms. — The  local  symptoms  of  cow-pox  in  the  cow  are 
seldom  accompanied  by  any  material  constitutional  disturbance ;  in  the 
great  majority  of  animals,  feeding  and  grazing  go  on  as  usual.  The  secre¬ 
tion  of  milk  is  sometimes  diminished ;  and,  in  most  instances,  the  amount 
artificially  obtained  is  greatly  lessened  from  the  trouble  and  difficulty 
of  milking.  In  some  cases  the  cow  exhibits  in  the  course  of  vaccinia 
a  peculiar  vesicular  eruption  very  like  vesicular  varicella.  It  occurs  gen¬ 
erally  about  the  ninth  or  tenth  day,  commencing  with  erythemato-papular 
elevations,  which  in  tweuty-four  hours  have  become  vesicles  full  of  pellu¬ 
cid  serous  fluid.  Next  day  this  fluid  is  straw-colored,  and  it  becomes 
speedily  turbid,  the  cuticle  collapses  or  bursts,  turns  yellowish-brown,  and 
before  the  fifth  day  from  their  origin,  the  vesicles  desiccate  with  brown  or 
black  thin  flimsy  crusts,  which  soon  fall  off. 

Spurious  Pocks. — The  cow  is  liable  to  other  diseases,  which  more  or  less 
resemble  cow-pox,  and  from  which  it  is  important  to  distinguish  it — a  dis¬ 
tinction  all  the  more  necessary  that  some  of  these  diseases  may,  and  in 
fact  not  uncommonly  do,  either  co-exist  with  it,  or  immediately  precede  or 
follow  it.  Besides  certain  cutaneous,  sub-cutaneous  and  follicular  inflam¬ 
mations  and  suppurations  on  the  udder  and  teats,  which  are  liable  to  affect 
occasionally  the  hands  of  the  milkers,  warty  growths  and  even  warty  vesi¬ 
cles,  and  eczema,  or  other  superficial  vesicular  eruptions,  three  kinds  of 
spurious  cow-pox  have  been  described  by  Ceely. 

The  Yellow  Pock ,  a  pustular  eruption,  resembling  ecthyma  on  the  teats 
and  udders,  succeeded  by  thin  dirty-brown,  or  black  irregular  crusts. 

The  Bluish  or  Black  Pock. — Bluish  or  black  or  livid  vesications  on  the 
teats  and  udders,  followed  by  thiu  dirty-brown  or  black  irregular  crusts, 
and  some  degree  of  impetigo  on  the  interstics,  near  the  base  of  the  teats. 

The  White  Pock. — A  highly  contagious  disease  among  milch  cows  and  to 
the  milkers,  quickly  causing  vesications  and  deep  ulcerations,  often  or  al¬ 
ways  confounded  by  them  with  the  true  vaccine,  and  certainly  not  readily 
distinguishable  in  all  its  stages  by  better  informed  persons  than  milkers. 

Diagnosis  of  True  Cotv-pox. — Although  broad  and  palpable  grounds  of 
distinction  may  be  found  between  vaccinia  and  white- pock,  in  the  character 
of  the  genuine  vaccine  eruption,  its  cellular  structure,  its  hard  and  knotty 
feel,  its  glistening  aspect,  its  tardy  and  progressive  changes  to  the  vesicu¬ 
lar  form,  its  central  depression  and  its  late  acumination,  the  necessity  for 
caution  and  accuracy  of  diagnosis  must  be  borne  in  mind.  Edward  Jenner 
pointed  out  that  milkers  were  very  liable  to  contract  infection  from  spurious 
pocks,  and  to  acquire  in  consequence  false  and  delusive  ideas  as  to  their 
having  immunity  from  small-pox;  and  Ceely  states  that  he  has  in  several 
instances  known  milkers  who  undoubtedly  had  made  this  mistake  suffer 
afterwards  from  small-pox,  while  in  other  instances  he  has  discovered  the 


Relations  of  Coiv-Pox  to  Small-Pox. 


227 


mistake  be  had  made  in  time  to  save  the  subjects  of  it  from  small-pox,  by 
performing  successful  vaccination  in  the  ordinary  way.  The  white  or 
blister-pock  in  the  human  subject  exhibits  sometimes,  in  fact,  an  appearance 
exceedingly  like  that  of  real  cow-pox,  so  that,  as  in  tl\e  case  with  the  two 
diseases  in  the  cow,  some  care  may  be  necessary  to  distinguish  them.  It 
is  communicable  by  inoculation  from  one  human  subject  to  another,  and 
may  be  communicated  repeatedly  to  the  same  subject.  Mr.  Ceely  success¬ 
fully  inoculated  himself  three  or  four  times  with  the  virus  ot  white  or 
blister-pock.  Other  diseases  of  the  cow  besides  white-pox  may  be  con¬ 
tracted  by  milkers  and  communicated  from  them  to  other  human  subjects. 
Mr.  Ceely  relates  a  case  in  which  a  whole  family  (a  wife  and  five  children) 
labored  under  a  pustular  disease  of  the  character  of  ecthyma,  from  infec¬ 
tion  by  the  father,  who  had  himself  caught  the  disease  from  a  cow,  de¬ 
scribed  as  being  in  a  terrible  condition. —  Robert  Ceely ,  Transactions  Provinc¬ 
ial  Medical  and \  Surgical  Association ,  vol.  8,  vol.  10.  A  Hand-Boolc  of  Vac¬ 
cination ,  by  Edward  C.  Seaton ,  M.D. ,  Medical  Inspector  to  the  Privy  Council  ; 
London  ;  Macmillan  &  Co.,  1868;  pp.  1-11. 


COW-POX — RELATIONS  OF  COW-POW  TO  NATURAL  AND  IN¬ 
OCULATED  SMALL-POX. 


COMPARATIVE  VIEW  OF  THE  NATURAL  SMALL-POX,  INOCULATED  SMALL¬ 
POX  AND  COW-POX— MICROSCOPICAL  CHARACTER  OF  THE  COW-POX, 
(VACCINE)  LYMPH,  AND  OF  THE  CONTAGIOUS  MATTER  FROM  THE  PUS¬ 
TULES  OF  SMALL-POX— COMPARATIVE  PHENOMENA  OF  INOCULATED 
SMALL-POX  AND  COW-POX— COMPARATIVE  PHENOMENA  AND  RELATIONS 
OF  VARIOLA  AND  VARIOLOID— DETAILED  DESCRIPTION  OF  THE  ILLUS¬ 
TRATIONS  OF  COW-POX,  VACCINE  DISEASE,  CONFLUENT  SMALL-POX 
DISTINCT  SMALL-POX  AND  VARIOLOID— DEVELOPMENT  AND  STRUCTURE 
OF  THE  SMALL-POX  PUSTULES— CHANGES  OF  THE  TEMPERATURE  AND 
■  URINE  IN  VARIOLA  (SMALL-POX)  AND  IN  VARIOLOID  (MODIFIED  SMALL. 
POX). 


COMPARATIVE  VIEW  OF  THE  NATURAL  SMALL  POX,  INOCU¬ 
LATED  SMALL  POX  AND  COW-POX. 

The  relation  of  Inoculated  Cowt-Poy  ( Vaccina),  to  the  natural  and 
inoculated  smallpox ,  were  formulated  iu  terse  and  unequivocal  terms,  shortly 
after  the  discovery  of  Jenner  had  resulted  in  the  foundation  of  the  Royal 
J en nerian  Society . 

The  views  held  and  propagated  by  the  advocates  of  vaccination,  were 
condensed  and  forcibly  expressed  in  the  following  comparative  view  of  the 
natuaral  smallpox,  inoculated  small-pox  and  inoculated  cow-pox,  drawn  up  by 
John  Addington*  and  published  by  order  of  the  Medical  Council  ot  the 
Royal  Jennerian  Society,  for  the  extermination  of  the  small-pox. 


Medical  Repository,  etc.,  Second  Hexaude,  vol.  1,  Now  York,  1604,  p.  313. 


228 


Relations  of  Core- Pox  to  Small-Fox. 


A  COMPARATIVE  VJEW  OF  THE  NATURAL  SMALL  POX,  IN¬ 
OCULATED  SMALL  POX  AND  COW-POX. 


NATURAL  SMALL-POX- 


HISTORY,  GENERAL  CHARACTER,  MOR¬ 
TALITY. 


Circumstances,  independent  of  contagion  and  mor' 
tality,  viz  :  Danger,  eruptions,  confinement,  loss  of 
time,  expense,  requisite  precautions,  medical  treat¬ 
ment,  deformity  and  subsequent  diseases. 


Eor  twelve  centuries  tlie  disease  has  been  known 
to  continue  its  ravages,  destroying  in  every  year  an 
immense  proportion  of  the  whole  population  of  the 
world . 


A  contagious  disease, 
in  some  instances  mild, 
but  for  the  most  part  vio¬ 
lent,  painful,  loathsome 
and  dangerous  to  life. 


One  in  six  who  have  the 
disease  dies.  At  least 
half  of  mankind  have  it; 
consequently  one  in 
twelve  of  the  human  race 
perish  by  one  disease.  In 
London.  3000  annually; 
in  the  United  Kingdom, 
40,000  ' 


1.  One  in  three  has  the  natural  small-pox  in  a 
dangerous  form . 

2.  It  produces  eruptions,  numerous,  painful  and- 
disgusting. 

3.  Occasions  confinement. 

4.  Loss  of  time;  and 

5.  Expense  more  or  less  considerable,  affecting  in¬ 
dividuals,  families,  parishes,  etc. 

0.  Renders  precautions  for  the  most  part  unavail¬ 
ing. 

7.  Medical  treatment  necessary  both  during  treat¬ 
ment  and  afterwards. 

8.  Leaves  pits,  scars,  seams,  etc.,  disfiguring  the 
skin,  especially  the  face  ;  and,  is  followed  by  scrofula 
in  every  form,  diseases  of  the  skin,  glands,  joints, 
etc.,  blindness,  deafness,  etc.,  etc. 


INOCULATED  SMALLPOX. 


A  contagious  disease,  for 
most  part  mild,  but  in 
some  instances  violent, 
painful',  loathsome,  and 
dangerous  to  life. 


One  in  three  hundred  in¬ 
oculated  dies. 

In  London,  probably 
one  in  one  hundred. 


The  inoculation  of  the  small  pox  having  been  but 
partially  adopted,  has  become  the  means  of  spread¬ 
ing  the  infection,  and  has  thus  increased  its  general 
mortality.  In  London  this  increase  has  been  in  the 
proportion  of  seventeen  in  every  thousand. 


1.  One  in  thirty  or  forty  has  had  inoculated  small 
pox  in  a  dangerous  form. 

2.  It  produ  ces  eruptions  in  greater  or  less  numbers. 

3.  Occasions  confinement. 

4  Loss  of  time;  and 

5.  Expense,  sometimes  considerable. 

6.  Requires  preparation  by  diet  and  medicine;  care 
to  avoid  certain  seasons, as  extremes  of  heat  and  cold; 
certain  periods  of  life,  as  early  infancy  and  old  age; 
and  certain  states  of  constitution,  as  general  ill- 
health,  teething,  pregnancy,  etc.,  etc. 

7.  Renders  medical  treatment  usually  necessary. 

8.  Is  liable  to  produce  deformities  whenever  the 
disease  proves  severe  ;  and  to  be 

9.  Followed  by  the  diseases  as  above  enumerated, 
but  less  frequently. 


INOCULATED  COW-POX. 


N’ot  contagious  ;  and 
when  properly  conducted 
uniformly  mild,  inoffen¬ 
sive,  free  from  pain  or 
danger ,  and  an  infallible 
preventive  of  the  small¬ 
pox. 

During  a  long  series  of  years  the  cow-pox  accidently 
received,  has  been  considered  as  a  preservative  against 
any  future  attack  of  the  small-pox.  Many  persons  in 
the  dairy  countries,  who  have  had  the  former  in  their 
youths,  have  remained  to  old  age  unsusceptible  of 
the  latter. 


1.  The  inoculated  cow-pox  is  attended  by  no 

danger. 

2.  Produces  a  pustule  in  the  inocidated  part  only. 

3 .  Occassions  neither  confinement, 

4.  Loss  of  time,  nor, 

5.  Expense; 

6.  Demands  no  other  precautions  than  such  as 
respect  the  conduct  of  the  inoculated  ; 

7 .  Requires  no  medicinh ; 

8.  Leaves  no  deformity  nor  disfiguration 

9.  Excites  no  subsequent,  diseases. 


NEVER 

FATAL. 


NATURE  OF  THE  VIRUS  OR  CONTAGIUM  OF  COW-POX  AND 

SMALL-POX. 

Tlie  virus  of  cow-pox  is  not  known  to  be  communcaible  otherwise  than 
by  direct  contact  or  inoculation. 

In  this  respect,  therefore,  it  differs  from  its  congeners,  the  coniagia  of 
small-pox  and  variolse  ovium,  both  of  which  are  believed  to  be  readily  com¬ 
municable  through  the  air.  Considering  the  very  close  analogies  which 


Nature  of  the  Virus  of  Cow-Pox  and  Small- Pox. 


229 


subsist  between  these  three  diseases,  it  has  been  held  with  reason  that  this 
contrast  may  be  due  not  so  much  to  any  intrinsic  difference  between  con¬ 
tagious  particles  by  which  they  are  respectively  propagated,  as  to  differ¬ 
ences  in  the  amount  of  virulent  matter  generated  in  the  infected  organism, 
and  in  the  facilities  afforded  for  the  distribution  of  this  matter  through  the 
surrounding  medium.  Inasmuch  as  not  one  of  the  three  contagia  is  vola¬ 
tile,  infection  at  a  distance  can  only  take  place  by  the  transfer  of  particles 
derived  from  the  diseased  individual  to  some  absorbent  surface  in  the 
healthy  one.  Such  absorbent  surfaces  are  to  be  found  in  the  mucous  mem¬ 
branes  lining  the  air  passages  and  the  alimentary  canal.  That  the  virulent 
mutter  is  capable  of  being  absorbed  from  the  intestinal  surface,  and  caus¬ 
ing  all  the  phenomena  of  constitutional  infection,  has  been  experimentally 
proved  in  the  case  of  ovine  variola;  and  the  result  may  reasonably  be 
extended  to  the  two  allied  disorders. 

Experiments  with  reference  to  the  introduction  of  small-pox  virus  into 
the  system  through  the  channel  of  the  alimentary  canal  appear  to  have 
been  made  as  early  as  1792  (six  years  before  Dr.  Jenner  published  his  In¬ 
quiry  oil  the  Variolce  Vaeeince) ,  as  will  be  seen  from  the  following 
statement : 


SMALL-POX  COMMUNICATED  TO  MAX  AND  ANIMALS  BY  EAT¬ 
ING  THE  SMALL  POX  MATTEE,  IN  1792. 

John  Maisillse  gives  the  following  facts,  in  the  Bulletin  de  la  Societe  Philomatique,  for 
October  and  November,  1792: 

“A  peasant  of  the  County  of  Essex  having  a  great  many  children  carried  off  by  the 
natural  small-pox,  was  desirous  of  inoculating  his  two  boys — one  nine  and  the  other 
twelve  years  old.  Not  being  able  to  employ  a  surgeon,  he  collected  the  scabs  of  a  child 
then  sick  of  the  disease,  powdered  them,  and  sprinkled  the  powder  upon  slices  of  bread 
and  butter.  The  two  sons  eat  them,  and  gave  a  bit  to  the  housedog.  They  had  a  mild 
small-pox,  and  got  well  without  any  remarkable  accident.  The  dog  remained  sick  for 
two'  or  three  days,  drinking  a  great  deal  and  refusing  to  eat ;  on  the  fourth  he  had  a  very 
decided  variolous  eruption  ;  on  the  ninth  the  pustules  were  full  ripe  and  dried  up,  and 
fell  off  like  those  of  the  two  children.  An  English  author  says  he  has  observed  the  same 
epidemic  in  a  dock  of  sheep,  the  greater  part  of  which  were  affected,  and  communicated 
it  to  two  cows,  one  of  which  died.  The  symptoms  that  manifested  themselves  in  these 
animals,  in  the  course  of  the  disease,  were  in  every  respect  the  same  as  are  observed  in 
the  human  species.” — The  Medical  Repository ,  vol.  1,  Third  Edition ;  New  York,  1804;  p.  247. 

When  wo  consider  the  number  of  distinct  foci,  each  yielding  a  large 
amount  of  infective  matter,  distributed  over  the  skin  of  a  man  affected 
with  small-pox,  or  of  a  sheep  suffering  from  the  severe  form  of  ovine  vari¬ 
ola;  when  we  recollect  further,  that  similar  infective  foci  exist  elsewhere 
in  the  body,  as  in  the  mouth,  fauces  and  throat  of  man,  and  in  the  lungs  of 
the  sheep,  while  secondary  nodules  full  of  virulent  particles  are  often  de¬ 
veloped,  in  situations  which  enable  their  products  to  be  discharged  into 
the  surrounding  medium  by  respiration  and  by  coughing ;  we  cannot  but  be 
struck  with  the  contrast  between  these  two  diseases  and  cow-pox  as  it  oc¬ 
curs  after  inoculation  in  the  human  subject.  The  quantity  of  infective 
material  generated  in  cow-pox,  though  very  considerable  in  relation  to  the 
amount  introduced,  falls  very  far  short  of  the  common  supply  yielded  by  a 
single  case  of  ovine  or  human  variola  ;  and  what  there  is,  is  generated  in  a 
situation  which  absolutely  precludes  its  distribution  throughout  the  envir¬ 
onment,  at  least  during  the  period  when  the  infection  of  the  contagion  is 
at  its  highest. 

Since  the  difference  between  the  communicability  ot  vaccinia  on  the 
one  hand  and  of  small-pox  on  the  other,  admits  of  being  thus  easily 


230 


Nature  of  the  Virus  of  Cow-Pox  and  Small-Pox. 


explained ;  it  appears  that  the  difference  is  one  of  degree  only,  and  that 
deductions  from  experiments  performed  with  the  contagia  of  cow-pox  may 
he  extended  to  variola.* 

Cow-pox  and  small  pox,  whether  inoculated  or  arising  in  the  natural  way, 
are  attended  during  the  active  stage  of  the  development  and  increment  of 
the  specific  contagion,  by  febrile  pyrexia. 

The  recognized  characteristics  of  fever,  are  those  which  relate  either  to  the 
disintegration  of  the  living  substance  of  the  body,  or  to  the  increase  and 
diminished  constancy  of  the  bodily  temperature ;  but  it  is  essential  to  the 
correct  definition  of  fever  that  it  should  comprehend  particulars  relating  to 
its  origin,  progress  and  termination  ;  in  other  words  fever  is  not  merely  a 
state  but  a  process.  Fever  has  its  beginning  in  the  entrance  into  or  action 
on  the  organism  of  some  affecting  or  infecting  cause.  After  this  event  fol¬ 
lows  the  period  of  latency ;  and  it  is  not  until  it  is  passed  that  the  first 
indications  within  the  affected  organism  begin  to  manifest  themselves.  The 
state  of  fever  once  established,  it  may  vary  in  its  course,  in  its  duration,  and 
in  the  local  inflammation  which  accompany  it;  but  in  all  cases  it  has  its  onset, 
accession,  and  declension,  each  of  which  is  characterized  by  more  or  less 
distinctive  phenomena. 

Two  hypothesis  have  been  framed  as  to  the  nature  of  fever,  however  ex¬ 
cited. 

One  is  that  fever  originates  in  disorder  of  the  nervous  centres,  that  by 
means  of  the  influence  of  the  nervous  system  on  the  systemic  functions, 
the  liberation  of  heat  at  the  surface  of  the  body  is  controlled  or  restrained, 
so  that  by  rete7ition  the  temperature  rises,  and  finally  that  the  increased 
temperature  so  produced  acts  on  the  living  substance  of  the  body  so  as  to 
disorder  its  nutrition. 

The  other  is,  that  fever  originates  in  the  living  tissues,  that  it  is  from 
first  to  last  a  disorder  of  protoplasm,  and  that  all  the  systemic  disturb¬ 
ances  are  secondary. 

In  both  hypotheses  it  is  tacitly  admitted  that  fever  is  the  product  of  a 
natural  fever-producing  cause  contained  in  the  blood  or  tissue  juice,  the  mor¬ 
bific  action  of  which  in  the  organization  is  antecedent  to  all  functional  dis¬ 
turbances  whatever. 

The  first  hypothesis  must  be  rejected,  because,  on  the  one  hand,  no  dis¬ 
order  of  the  systemic  functions,  or  of  the  nervous  centres  which  preside 
over  them,  is  capable  of  inducing  a  state  which  can  be  identified  with 
febrile  pyrexia;  and  on  the  other,  that  it  is  possible  for  such  a  state  to  orig¬ 
inate  and  persist  in  the  organism  after  the  influence  of  the  central  nervous 
system  has  been  withdrawn  from  the  tissues  by  the  severance  of  the  spinal 
cord. 

It  appears  to  be  more  rational  to  adopt  the  hypothesis  of  the  tissue  or¬ 
igin  of  f evert. 

Dr.  J.  Burdon  Sanderson  (2)  has  shown  by  experimental  investigations 
that  whatever  may  be  the  nature  of  the  poisonous  agent,  which  produces 
septic  fever  and  infective  inflammations,  it  admits  of  complete  removal  by 
mechanical  filtration.  It  is  therefore  material  and  particulate. 


*  Dr.  Baxter’s  Report.  on  an  Experimental  Study  of  Certain  Disinfectants.  Reports  of  the  Medical  Olli 
cer  of  the  Privy  Council  and  Local  Government  Board,  New  Series,  vol.  6  ;  London,  1876,  p,  216. 

tDr.  J.  Burdon  Sanderson  on  the  Process  of  Fever.  Public  Health  Reports  of  the  Medical  Officer  of  the 
Privy  Council  and  Local  Government  Board ;  New  Series,  vol.  1,  London,  1875,  pp,  9,  40,  42,  47 ;  vol.  2,  1876. 


Microscopical  Characters  of  Vaccine  and  Small-Pox  Matter. 


231 


MICROSCOPICAL  CHARACTERS  OF  VACCINE  (COW-POX)  LYMPH 
AND  THE  CONTAGIOUS  MATTER  FROM  THE  PUSTULES  OF 
SMALLPOX. 

There  are  a  few  contagious  diseases  in  respect  of  which  the  presence  in 
the  contagious  liquids  of  forms  of  vegetation  differing  from  those  met 
with  either  after  death  in  the  normal  tissue  or  liquids  of  the  body,  or  dur¬ 
ing  life  in  the  products  of  primary  or  secondary  inflammations,  lias  been 
established.  These  are  small  pox,  slieep-pox,  splenic-fever  and  relapsing 
fever. 

The  first  statements  as  to  the  existence  of  organisms  iu  the  lymph  of 
cowpox  was  made  by  Dr.  Keber,*  of  Dantzic,  in  1868,  who  regarded  them 
as  the  carriers,  if  not  the  generators,  of  the  active  virulent  principle. 

In  1869,  Dr.  Burdon  Sandersonf  began  a  series  of  most  valuable  cetiologi- 
cal  researches  in  a  new  direction,  and  in  his  first  paper  on  the  pathology  of 
contagion,  published  in  1870,  he  gave  an  account,  accompanied  by  a  wood 
cut  of  certain  bodies  to  which  lie  assigned  the  name  of  microzymes,  the 
presence  of  which  he  found  it  was  usually  possible  to  demonstrate  in  vac¬ 
cine  liquid.  Dr.  Sanderson  was  not  able,  however,  to  assert  that  their  pres¬ 
ence  was  or  was  not  essential  to  the  infective  activity  of  the  virus. 

In  1863,  Dr.  Lionel  Beale  described  in  a  paper  which  appeared  in  the 
u Microscopical  Journal,”  for  April,  1864,  the  existence  of  transparent  hya¬ 
line  particles,  of  extreme  minuteness,  in  vaccine  lymph.  These  particles 
lie  regarded  as  masses  of  living  matter,  or  germinal  matter.  In  a  subse¬ 
quent  research  on  the  same  subject,  an  account  of  which  appeared  in  the 
Report  of  the  Royal  Commission  on  Cattle  Plague,  his  previous  results 
were  confirmed.  Both  papers  contain  drawings  of  the  particles.  Since  that 
time,  vaccine  lymph  has  been  examined  by  many  other  skillful  observers, 
all  of  whom  agree  that  the  liquid,  notwithstanding  its  apparent  limpidity, 
contains  minute  particles.  In  the  papers  referred  to,  Dr.  Beale  expressed 
his  opinion  that  the  contagious  principle  resided  in  the  granules,  but  he 
did  not  offer  any  experimental  proof  of  its  being  so. 

At  this  point  the  investigation  was  taken  up  by  Dr.  Chauveau,  of  Lyons, 
who,  without  knowing  of  the  observations  of  Dr.  Lionel  Beale,  had  also  found 
that  vaccine  lymph  contains  particles.  Using  the  large  field  at  his  disposal, 
as  professor  in  the  Government  Veterinary  School  at  Lyons,  he  has  carried 
out  a  number  of  experiments  as  to  the  physical  character  of  infective  liquids 
in  thecommunicable  diseases  of  animals.  His  earliest  researches  weredirected 
to  the  relation  between  cow-pox  and  small-pox,  and  are  contained  iu  well 
known  reports  on  these  diseases  published  at  Lyons  in  1865|. 

Subsequently,  M.  Chauveau  directed  his  attention  to  the  question  of  the 
nature  of  the  contagious  process  in  general,  taking  as  his  basis  an  inquiry 
into  the  physical  characters  of  vaccine. 

Mature  vaccine  lymph  contains  in  suspension  two  kinds  of  particles.  In 
the  first  place,  bodies  are  generally  met  with  analogous  to  pus  corpuscles. 
They  do  not  differ  from  the  corpuscles  which  occur  in  pus  in  an  early  stage 
of  formation,  as  in  the  liquid  of  a  blister  when  first  becoming  op  descent. 
But  besides  those  particles  vaccine  contains  particles  far  inferior  to  them 
in  size,  not  exceeding  indeed  1-20,000  of  an  inch  in  diameter. 

*Keber.  Ueber  die  microscopisclieu  BestandtheilederPocken — Lvmphe,  Virchows  Archir,  vol.  42,  p.  112' 

Reports  on  recent  researches  on  the  Pathology  of  tlio  Infective  Processes,  by  J .  Burdon  Sanderson. 

Public  Health  Reports  of  the  Medical  Officer  of  the  Privy  Council  and  Local  Grovermnent  Board ;  New 
Series,  vol.  3,  London,  1.874,  pp.  11-48. 

tlntroductory  Report,  by  Dr.  Burdon  Sanderson,  on  the  intimate  Pathology  of  Contagion.  Public  Health  . 

Twelfth  Report  of  the  Medical  Officer  of  the  Privy  Council,  1869  ;  London,  1870,  pp.  229-256. 

{Vaccine  ot  (Variola,  etude  experiinentalo  sur  la  question  de  l'identitd  de  ces  deux  affections,  Paris,  1865. 


232 


Microscopical  Characters  of  Vaccine  and  Small-Pox  Matter. 


Starting  from  these  facts,  M  Ohauveau  proceeded  to  inquire  by  experi¬ 
ment,  in  which  of  those  three  elements  of  which  vaccine  consists  (viz.,  the 
leucocytes,  the  minute  particles,  and  the  clear  liquid  in  which  they  float) 
the  activity  of  the  vaccine  resides. 

By  careful  experiments  M.  Ohauveau  (1)  has  proved  that  the  leucocytes 
contain  nothing  essential  to  the  activity  of  vaccine  lymph;  and  also  that 
the  fluid  portion  freed  from  the  minute  particles  although  containing  all  the 
soluble  constituents  of  vaccine,  is  wanting  in  those  upon  which  its  activity 
depends. 

The  experiments  of  Ohauveau  were  perfected  and  repeated  by  Dr.  Burdon 
Sanderson  in  18(59,  and  their  accurancy  was  confirmed  and  the  result  estab¬ 
lished  that  the  infective  property  of  vaccine  lymph,  resides  in  the  minute 
particles;  although  the  proposition  was  not  announced  by  Dr.  Sanderson 
and  Ohauveau.  About  the  same  time  Professor  Klebs,  (2)  described  the 
minute  particles  of  vaccine  in  his  handbook  of  Pathology(3). 

Two  years  afterwards,  Professor  Ferdinand  Cohn,  (4)  of  Breslau  treated 
of  this  subject.  His  observations  relate  both  to  vaccine  and  variolous 
lymph,  atid  led  to  the  interesting  discovery  that  the  organisms  (minute  par¬ 
ticles)  discovered  in  vaccine  lymph  by  Lionel  Beale,  Ohauveau,  Klebs  and 
Burdon  Sanderson,  are  also  found  in  the  variolous  lymph,  and  present 
characters  so  entirely  similar,  that  it  is  not  possible  to  draw  any  distinc¬ 
tion  between  them,  either  as  regards  form  or  development. 

According  to  Professor  Ferdinand  Cohn,  vaccine  and  varioious  lymph  is 
always  to  be  found  filled  with  spheroidal  particles  or  corpuscles,  which, 
although  they  exhibit  molecular  motion,  have  no  motion  of  their  own. 
They  are  extremely  small,  and  in  their  reaction  on  light  differ  little  from 
the  serum  in  which  they  are  suspended,  on  which  account  they  are  easily 
overlooked.  It  is  difficult  to  determine  the  diameter  of  the  spheroids  mi- 
crometrically,  but  Professor  Cohn  estimates  it  about  three-quarters  of  a 
micromillimeter.  In  addition  to  these,  numerous  larger  and  more  refrac¬ 
tive  bodies  are  found  in  the  lymph,  as  regards  which  it  is  difficult  to  say 
whether  they  are  fat  globules  or  result  from  further  development  of  the 
others.  It  seems  most  probable  that  they  are  cells,  each  of  which  consists 
of  a  dark  central  part,  surrounded  by  a  membrane  indicated  by  a  clearer 
ring,  an  appearance  often  seen  in  stages  of  division.  In  perfectly  fresh 
preparations  most  of  the  corpuscles  are  simple,  others  being  joined  together 
in  a  form  resembling  the  figure  8.  After  the  preparation  has  been  kept, 
the  number  of  these  double  cells  increases,  and  soon  chains  of  four  begin 
to  be  distinguishable. 

These  chains  are  usually  curved  or  in  zigzag;  their  attachment  one  to 
another  is  evidently  very  slight,  as  they  can  readily  be  displaced.  After 
one  or  two  hours,  numerous  necklaces  present  themselves,  usually  of  eight 
joints,  which  are  even  more  readily  broken  up  than  the  others.  In  this 
displacement  the  groups  are  to  be  attributed ;  of  these,  some  resemble 
sareina},  but  it  is  to  be  observed  that  no  true  sarcinae  showing  crucial  divi¬ 
sion  present  themselves.  Obviously  the  very  rapid  and  uninterrupted 
multiplication  of  the  spheroids  takes  place  by  a  process  of  repeated  trans¬ 
verse  division, in  which  the  septa  are  parallel,  so  that  the  resulting  daughter 
cells  are  arranged  in  necklaces  like  the  spores’of  a  penicillium.  In  conse¬ 
quence  of  their  very  slight  attachment  to  each  other,  it  is  only  at  the  be¬ 
ginning  that  the  original  grouping,  due  to  their  mode  of  development,  is 


1  Determination  expenmen  tain  ties  616ments  qui  constituent  le  principe  actif  de  la  serosite  vaccinale 
virulente.  Comptes  Itendus,  LXVIII.  1868,  p.  289. 

2  Twelfth  report  of  the  medical  officer  of  the  Privy  Council,  London,  1870,  p.  238. 

3  Klebs,  Handbuch  des  Pathologie,  vol.  1,  p.  40. 

4  Cohn,  Organismen  in  des  Pockenlymphe  Virchows  Arehir,  vol.  55,  p.  229. 


Phenomena  of  Inoculated  Small-Pox  and  Cow-Pox. 


233 


traceable.  After  a  few  boars’  observation  they  are  sure  to  be  all  aggre¬ 
gated  into  irregular  colonies  or  clumps,  each  consisting  of  sixteen,  thirty- 
two,  or  more,  corpuscles.  The  multiplication  of  cells  lasts  for  several  days, 
the  aggregations  becoming  larger  and  larger.  In  capillary  glass  tubes 
the  multiplication  of  colonies  sometimes  lasts  a  long  time,  so  that  they  ac¬ 
quire  considerable  size,  and  present  themselves  as  flocculi.  By  the  forma¬ 
tion  of  mucous-like  interstitial  substance  the  corpuscles  become  intimately 
united  with  each  other,  the  mass  being  converted  into  zooglcea.  When 
this  is  the  case,  the  size  of  the  individual  cells  increases,  their  contents  be¬ 
coming  more  refractive,  so  as  to  resemble  oil  drops.  As  these  agglomerations 
are  apt  to  be  encrusted  with  other  bodies  derived  from  the  lymph,  the  char¬ 
acters  which  indicate  their  origin  become  indistinct.  It  often  happens  that 
the  changes  described  are  associated  with  the  appearance  of  acicular  crys¬ 
tals  resembling  raphides. 

Some  months  before  the  appearance  of  the  paper  of  Professor  Cohn, 
containing  the  preceding  facts  with  reference  to  the  organisms  of  vaccine 
and  variolous  lymph,  etc.,  Weigert,*  of  Breslau,  published  a  short  commu¬ 
nication  founded  on  the  microscopical  examination  of  the  skin  in  patients 
who  had  died  of  small-pox,  in  which  he  stated  that  he  had  found  the  lymph¬ 
atics  plugged  with  a  granular  mass  which  exhibited  all  the  characters  of 
micrococci. 

The  fact  that  organisms  of  a  particular  form  exist  in  the  lymph  of  small¬ 
pox,  taken  in  connection  with  the  occurrence  of  similar  organisms  in  the 
channels  of  absorption  leading  from  the  pustules,  suggest  the  probability 
of  their  having  to  do  with  the  morbid  process. 

During  the  smal  1-pox  of  Hew  Orleans  of  1881,  1882  and  1883,  I  have 
repeated  the  observations  of  Kolin  and  obtained  similar  results  with  re¬ 
ference  to  the  spheroidal  particles  or  corpuscles  of  vaccine  and  variolous 
lymph. 


COMPARATIVE  PHENOMENA  OF  INOCULATED  SMALL  POX 

AND  COW-POX. 


INOCULATED  SMALL-POX. 

Inoculation  is  performed  by  introducing  into  the  arm,  at  the  insertion  of 
the  deltoid,  by  means  of  a  lancet,  a  minute  portion  of  variolous  matter. 
The  thin  lymph  of  a  fifth  day  vesicle  is  to  be  preferred  to  the  well-con¬ 
cocted  purulent  matter  of  the  eighth  day,  but  both  are  efficient.  One  ineis 
ion  only  is  to  be  made.  A  minute,  orange-colored  spot  is  perceptible  by 
the  aid  of  the  microscope  on  the  second  day ;  on  the  third  or  fourth  day,  a 
sensation  of  pricking  is  experienced  in  the  part.  The  punctured  point  is 
hard,  and  a  minute  vesicle,  whose  centre  is  depressed,  may  be  observed  sur¬ 
mounting  an  inflamed  base.  On  the  fifth  day  the  vesicle  is  well  developed 
and  the  areola  commences.  On  the  sixth  day  the  patient  feels  stiffness  in 
the  axilla,  with  pain.  The  inoculated  part  has  become  a  hard  and  inflamed 
phlegmon.  The  subjacent  cellular  membrane  has  become  involved  in  the 
inflammatory  action.  On  the  evening  of  the  seventh,  or  early  on  the  eighth 
day,  rigors,  headache,  a  fit  of  syncope,  vomiting,  an  offensive  state  of  the 
breath,  alternate  heats  and  chills,  langor,  lassitude,  or,  in  the  child,  an  epi¬ 
leptic  paroxysm,  announce  the  setting  in  of  fever.  The  constitution  has 
been  invaded  by  the  operation  of  the  contagium  from  the  local  disorder. 


*Weigert  ulin  Baltinen  in  der  Pockenliuut;  Contralblatt,  1871,  p.  609. 


234 


Phenomena  of  Vaccination. 


On  the  appearance  of  febrile  symptoms,  the  inflammation  of  tlie  arm 
spreads  rapidly.  An  areola  of  irregular  shape  is  soon  completed,  which 
displays  within  it  minute  confluent  vesicles. 

On  the  tenth  day  the  arm  is  hard,  terse,  shining  and  very  red.  The  pus¬ 
tule  discharges  copiously,  and  ulceration  has  evidently  penetrated  the 
whole  depth  of  the  corion. 

On  the  eighth  day  spots  of  variolous  eruptions  show  themselves  in 
various  and  often  in  the  most  distant  parts  of  the  body.  In  a  very  large 
proportion  of  cases,  the  eruption  is  distinct  and  moderate.  Sometimes  not 
more  than  two  or  three  papules  can  be  discovered,  which,  perhaps,  shrivel 
and  dry  up  without  going  through  the  regular  process  of  maturation.  At 
other  times  the  eruption  is  full  and  semi-confluent,  passing  through  all  the 
stages  of  maturation,  and  scabbing,  and  cicatrization,  with  as  much  per¬ 
fection  as  the  casual  disease  can  display.  Between  these  extremes  every 
possible  variety  may  be  observed.  The  truly  confluent  eruption  with  af¬ 
fection  of  the  mucous  membrane  is  very  rare,  and  that  implication  of  the 
fluids  and  solids  and  of  the  nervous  system,  which  together  constitute  the 
extreme  of  variolous  malignity  is  nearly,  if  not  entirely,  unknown. 

Secondary  fever  of  any  great  intensity  is  not  common.* 


INOCULATED  COW-POX— VACCINATION. 

The  symptoms  which  cow-pox  manifests  in  the  human  subject  resemble 
very  closely  those  observed  in  the  cow. 

If  vaccine  lymph  on  the  point  of  a  lancet  be  inserted  by  puncture  on  the 
arm  of  an  individual  who  has  not  been  before  vaccinated,  nor  has  suffered 
with  the  small-pox,  no  particular  local  effect  is  noticed  for  the  first  two 
days ;  but  at  the  eud  of  the  second  or  by  the  third  day,  a  slight  papular  ele¬ 
vation  is  perceptible,  which  by  the  fifth  or  sixth  day,  lias  become  a  distinct 
vesicle  of  a  bluish-white  color  with  a  raised  edge,  and  a  peculiar  central, 
up-like  depression.  By  the  eighth  day  (the  day  week  from  the  insertion 
ot  the  lymph)  this  vesicle  has  attained  its  highest  perfection,  is  plump, 
round,  and  more  decidedly  pearl-colored  ;  the  elevation  of  its  margin  and 
the  depression  of  its  centre,  are  more  marked.  At  this  date  or  a  few  hours 
earlier  a  ring  ot  inflammation  termed  the  areola,  begins  to  form  about  its 
base,  and  for  the  next  two  days  continues  to  spread.  It  is  circular  and, 
when  fully  developed,  has  a  diameter  of  from  one  to  three  inches,  and  is 
often  attended  with  considerable  hardness  and  swelling  of  the  subjacent 
connective  tissue.  The  establishment  of  this  areola,  is  the  anatomical  ev  i¬ 
dence  that  the  cow-pox  lias  produced  its  specific  effects  on  the  constitution. 
Other  proofs  of  the  constitutional  influence  of  the  vaccination  are,  its 
course,  generally  manifested  in  restlessness,  heat  of  skin,  with  derange¬ 
ment  of  the  stomach  and  bowels,  and  with,  in  some  cases,  swelling  of  the 
axillary  glands. 

These  general  symptoms,  though  seldom  altogether  absent,  are  often  ex¬ 
ceedingly  slight. 

After  the  tenth  day  the  areola  begins  to  fade,  the  vesicle  begins  to  dry 
in  the  centre,  the  lymph  remaining  in  it  becomes  opaque  and  concretes, 
and  by  the  fourteenth  or  fifteenth  day  a  hard,  brown  scab  is  formed,  which 
contracts,  dries,  blackens,  and  from  the  twentieth  to  the  twenty-fifth  days 
falls  off,  leaving  a  cicatrix  commonly  permanent,  and  which  in  character 
is  circular,  somewhat  depressed,  foveated  or  indented  with  minute  pits, 
and  sometimes  radiated. 


Lectures  on  the  Eruptive  Fsver,  by  George  Gregory,  M.  D.,  New  York,  1851,  pp.  108-110. 


Relations  of  Variola  and  Varioloid. 


235 


Occasionally  certain  constitutional  symptoms  beyond  those  already  de¬ 
scribed  are  observed  in  young  children  of  full  habit,  especially  iii  hot 
weather,  about  the  ninth  or  tenth  <jay,  when  the  areola  is  at  its  height,  an 
eruption  of  roseola  will  sometimes  take  place,  chiefly  on  the  extremities  ; 
sometimes  the  eruption  has  a  papular  form  (vaccine  lichen),  and  sometimes 
it  is  vesicular.  These  eruptions  are  generally  very  transitory  ;  their  ordi¬ 
nary  duration  does  not  extend  beyond  a  week,  and  they  very  seldom  last 
beyond  the  falling  of  the  scab. 

When  lymph  is  employed  that  is  derived  directly,  or  say  recently,  as 
either  three  or  four  removes  from  the  cow,  the  course  of  the  disease  is  gen¬ 
erally  retarded  at  various  stages.  Papulation  is  sometimes  deferred  till  the 
seventh,  eighth,  ninth  or  even  the  tenth  day,  and  the  areola  is  not  com¬ 
pleted  till  from  the  eleventh  to  the  fourteenth,  or  even  the  sixteenth  day. 
The  areola,  when  at  its  height,  is  more  indurated  than  is  observed  in  vac¬ 
cination  with  ordinary  humanized  lymph,  and  is  said  to  decline  and  revive, 
continuing  to  exhibit  a  brick-red  or  purplish  hue  while  the  hardness  re¬ 
mains.*  The  papular  and  vesicular  eruptions  which  occasionally  attend 
vaccination  with  humanized  lymph,  at  this  stage  of  its  course,  are  more 
frequently  seen.  The  vesicles  themselves  are  commonly  more  devel¬ 
oped  than  those  produced  by  ordinary  lymph.  Desication  is  generally 
prolonged,  and  the  crust  is  often  retained  till  the  fourth  or  fifth  week. 

Such  are  the  ordinary  phenomena  induced  by  primary  vaccination,  in  the 
human  subject.  The  course  however,  is  sometimes  modified ;  and  may  be 
simply  retarded,  simply  accelerated,  or  altogether  irregular  and  spurious. t 

The  anatomical  changes  in  the  skin  after  the  first  vaccination  clearly 
resemble  those  of  variola.  While  fever  never  occurs  at  the  commencement 
of  vaccinia,  the  stage  of  maturation  is  always  accompanied  by  a  secondary 
fever.  In  incomplete,  modified  vaccina,  the  inflammation  of  the  skin  some¬ 
times  causes  insupportable  itching,  sometimes  tense  or  burning  pain 

Prom  humerous  measurements  of  temperature,  Dr.  Felix  Yon  Wiemeyer,| 
has  satisfied  himself  that  the  patient  has  a  fever  which  is  not  at  all  in  pro¬ 
portion  to  the  intensity  and  extent  of  the  dermatitis.  Where  the  local  symp¬ 
toms  were  very  slight.  Dr.  Niemeyer  has  noticed  a  temperature,  of  104°. 
But  from  the  less  extent  of  the  dermatitis,  the  fever  never  becomes  so  high 
as  in  variola ;  it  cau  only  prove  dangerous  to  very  weakly  children,  and 
only  in  rare  cases.  It  is  rare  also  for  dangerous  erysipelas  or  pseudo-erysi¬ 
pelatous  inflammation  of  the  arm  to  occur  during  the  stage  of  maturation. 


PHENOMENA  AND  RELATIONS  OF  VARIOLA  AND  VARIO¬ 
LOID— PHENOMENA  OF  VARIOLA  (SMALLPOX). 

It  is  not  necessary  to  the  present  inquiry,  that  a  minute  description  should 
be  given  of  the  varieties  of  small-pox,  such  as  the  unmodified  5  confluent 
(pustules  running  together  over  the  greater  part  of  the  body;  semi-con¬ 
fluent;  distinct  or  discrete  (all  the  pustules  separate) ;  Petechial  Haemor¬ 
rhagic  (blood  effused  into  the  vesicle  or  pustules,  with  a  tendency  to  haemor¬ 
rhage  from  the  mucous  surfaces) ;  malignant ,  variola  nigra ,  blade  small-pox , 
variola  purpura  ;  variola  corymbosa. 

It  is  important  that  such  facts  should  be  recorded  as  illustrate  the 
difference  between  cow-pox  and  sinall-pox  on  the  one  hand,  and  vari¬ 
cella  (chicken-pox)  on  the  other  ;  and  also  to  determine ,  whether  the  modified 

*  Ceely ;  Observations  on  the  Variol;e  Vaccina).  Transactions  of  Prov.  Med,  and  Surg.  Association. 
Vol.  8,  p.  346. 

t Vaccination  by  Edward  Cator  Seaton.  M.  D. 

}A  Text  book  of  Practical  Medicine,  New  York,  1869,  vol.  2,  p.  559. 


23  G 


Phenomena  and  Relations  of  Variola  and  Varioloid. 


synall-pox  ( varioloid ),  in  which  the  pustules  are  cut  short  in  their  development 
by  vaccination  or  previous  attaclis  of  small-pox ,  presents  decided  differences  in 
its  thermometry  and  chemical  pathology. 

We  have  endeavored  to  present  a  comparative  view  of  the  appearances 
of  the  cow-pox  in  the  human  being1  and  in  the  cow,  and  also  of  the  discrete 
and  confluent  small-pox  and  of  the  modified  small-pox  ( varioloid ), 

Plate  17,  Figure  76,  represents  tlie  variola)  vaccinse.  This  drawing  represents  t.lie 
hand  of  Sarah  Nelmes,  infected  with  the  cow-pox  from  her  master’s  cow,  in  May,  1793. 
Dr.  Jenner  states  that  the  pustule  was  so  expressive  of  the  true  cow-pox,  as  it  commonly 
appears  upon  the  hand,  that  he  had  given  a  representation  of  it  in  Plato  1,  ot  his  “ In¬ 
quiry  into  the  Causes  and  Effects  of  the  Variola  Vaccina,”  Case  16,  p.  31. 

Plate  18,  *Variol^;  Vaccinse. — Figure  77,  arm  of  John  Baker,  vaccinated  March  16, 
1798  (Plate  2,  case  18.  Inquiry,  Edward  Jenner,  p.  35)  ;  Figure  78,  arm  ot  William  Pead 
(Plate  3,  case  20,  Inquiry,  Edward  Jenner,  p.  38);  Figure  79,  arm  of  Hannah  Excell, 
(Plate  4,  case  21,  Inouiry  into  Variolie  Vaccina),  Edward  Jenner,  p.  39). 

Plate  19.  Cow-Pox.— The  casual  cow-pox  on  the  teat  and  udder  of  a  black  and  white 
milch  cow,  after  Dr.  Ceely,  of  Aylesbury. 

Plate  20,  Small-Pox  (Variola).— Figure  81,  confluent  small-pox;  Figure  82,  confluent 
small-pox  ;  Figures  83,  84  and  85,  small-pox  pustules  (discrete  small-pox). 

Piate  21,  Varioloid  and  Variola. — Figure  86,  varioloid  (modified  small-pox) ;  Figure 
87  and  88  small-pox  eruption;  Figure  89,  varioloid  eruption;  Figure  90,  varioloid  eruption. 

It  is  important  that  the  cases  furnishing  the  Figures  in  Plates  20  and  21,  should  be 
examined  somewhat  in  detail. 

Plate  20,  figure  81;  portrait  delineation  of  the  confluent  small-pox  eruption*  as  it  ap¬ 
peared  on  the  tenth  day  after  it  broke  out  on  the  face  and  hand  of  a  female  patient, 
who  was  at  the  time  of  the  disease  in  the  small-pox  ward  of  La  Petid  Hospital  of  Paris. 
She  was  twenty-five  years  of  age,  and  had  never  been  protected  either  by  the  cow-pox  or 
the  variolous  disease. 

She  experienced  all  the  common  symptoms  which  generally  attend  this  form  of  variola, 
and  during  the  day  on  which  the  painting  was  executed  she  exhibited,  in  her  features, 
the  appearance  of  great  anxiety  and  distress  ;  the  general  swelling  of  the  face,  however, 
was  not  so  great  as  often  takes  place  in  cases  of  the  distinct  variola,  and  the  disease  was 
one  of  moderate  severity.  Some  of  the  pustules  about  the  nose,  mouth  and  chin  had 
begun  to  dry  up  and  look  scaly. 

After  the  tenth  day  desiccation  continued  to  progress,  and  on  the  fourteenth  day 
the  eruption  on  the  nose  and  the  other  parts  of  the  face  presented  the  appearance  repre¬ 
sented  in  figure  82,  plate  20. t 

From  this  date  the  disease  pursued  its  usual  course,  and  the  patient,  after  five  weeks 
of  illness,  was  able  to  leave  the  ward,  but  her  features  were  much  deformed  by  the  ex¬ 
tensive  ulceration  caused  by  the  eruption. 

Figures  83,  84  and  85  represent  the  discrete  and  confluent  small-pox  eruption  as  it  ap¬ 
peared  at  different  periods  on  the  face  and  hand  of  a  girl  aged  fourteen.  Figure  83,  fifth 
day  ;  figure  84,  seventh  day  ;  figure  85,  on  the  eleventh  day  of  the  eruption.! 

Plate  21,  figure  86,  represents  a  case  of  varioloid  or  modified  variolous  eruption  of  the 
distinct  kind,  as  it  appeared  on  the  fourth  day  of  its  development.  The  female  who  wa8 
the  subject  of  this  eruption  had  been  vaccinated  when  young,  and  the  marks  of  the  vac" 
cination  were  visible  on  her  arm.  The  scars  were  deep  and  smooth,  and  were  supposed 
from  their  general  appearance  to  be  the  results  of  a  spurious  disease.  On  the  ninth  of 
May,  1826,  she  experienced  some  unpleasant  chills,  which  were  accompanied  with  slight 
nausea.  These  were  soon  followed  by  flushes  of  heat,  pains  in  the  head,  back  and 
limbs,  and  by  considerab'e,  though  moderate,  fever.  On  the  twelfth,  and  after  three 
days  of  illness,  a  few  pimples  were  discovered  on  her  face  and  body.  The  pocks  were  in 
moderate  number,  and  amounted,  perhaps,  to  two  or  three  hundred.  They  were  more 


*The  paintings  from  which  plates  20  and  81,  figures  81  to  90,  were  engraved,  were  made  in  the  Hospitals 
of  Paris  during  the  years  1825  and  1826,  a  period  at  which  the  variolous  disease  prevailed  epidemically  in 
that  city.  They  were  executed  by  a  French  artist,  under  the  immediate  direction  of  Dr.  John  D.  Fisher, 
of  Boston,  Massachusetts,  and  were  all  begun  and  finished  at  the  bedside  of  the  patients  from  whom  they 
were  taken.  In  making  the  drawings  Dr.  Fisher  was  careful  to  attend  to  a  circumstance  of  some  import¬ 
ance,  in  attempting  an  accurate  and  intelligible  representation  of  the  diseases  intended  to  be  illustrated  by 
them  ;  neither  the  severest  nor  the  mildest  cases  were  selected,  but  those  of  moderate  severity,  as  it  was 
thought  that  delineations  of  the  maladies  equally  removed  from  the  two  extremes  would  be  the  best  calcu¬ 
lated  to  guide  the  inexperienced  practitioner  to  a  correct  diagnosis.  Dr.  Fisher  regarded  the  small-pox  and 
the  varioloid  as  one  and  the  same  disease,  and  that  the  chicken-pox  is  a  separate  and  independent  malady. 

Description  of  the  Distinct  Confluent  and  Inoculated  Small-Pox,  Varioloid  Disease,  Cow-Pox  and  Chicken- 
Pox.  Illustrated  by  thirteen  plates.  By  John  D.  Fisher,  M.  D.  Second  Edition.  Boston  :  1837. 

t  Description  of  the  Discrete,  Confluent  and  Inoculated  Small-Pox,  Varioloid  Disease,  Cow  Pox  and 
Chicken  Pox.  By  John  D.  Fisher,  M,  I).  Plate  5. 

iSmall-pox,  etc.,  J.  D.  Fisher,  M.  D.,  pp.  3-4. 


SMALL  POX  (Variola.) 


PLATE  20 


Fig,  81.*  Confluent  Small- Pox.  Fig.  82;  Con¬ 
fluent  Small-Pox.  Figs.  83,  84,  and  85/ 
Small-Pox  Pustules. 

Figure  81. 


Phenomena  and  Relations  of  Variola  and  Varioloid. 


237 


numerous  on  the  face  than  on  the  trunk  and  extremities.  The  pimples  were  papular  at 
first,  were  hard  to  the  touch  and  rather  painful  on  pressure,  and  before  the  termiua  tion 
of  the  second  day  the  tops  of  them  became  vesicular.  As  they  were  converted  into  ves¬ 
icles  they  increased  in  diameter  and  became  more  globular,  but  did  not  project  far  above 
the  common  surface.  On  the  third  day  the  pocks  were  all  converted  into  vesicles,  and 
were  tilled  with  a  yellowish  kind  of  serum.  On  the  fourth  day  they  had  attained  to 
the  full  s  ze,  and  the  eruption  exhibited  all  the  appearances  represented  in  the  portrait 
in  plate  21,  figure  86.  The  bases  of  the  pocks  were  still  surrounded  by  bright-red  areola, 
and  were  hard  and  tubucular  to  the  finger  The  fluid  contents  of  the  eruption  had  grown 
yellowish  and  more  consistent,  and  the  flattened  surfaces  of  some  of  the  pocks  had  be¬ 
come  slightly  discolored.  From  the  fourth  day  the  pocks  decreased  a  little  in  diameter, 
hut  diminished  proportionately  in  elevation,  and  in  a  few  instances  they  united  and  ran 
together.  The  matter  in  them  continued  to  grow  thicker  and  more  purulent  in  its  char¬ 
acter,  and  their  tops,  in  consequence  of  the  gradual  coagulation  or  congretion  of  the 
virus,  assumed  by  degrees  a  dry  and  discolored  appearance;  and  on  the  sixth  day  the 
pocks  had  flattened  considerably,  and  the  inflamed  areola  surrounding  them  had  dimin¬ 
ished  in  redness  and  breadth.  From  the  seventh  day  desiccation  proceeded  rapidly,  and 
by  the  eighth  the  virus  had  concreted  into  a  solid  mass.  In  drying,  the  pocks  were  formed 
into  reddish-brown  crusts  or  scabs,  and  during  this  process  they  gradually  became  shriv¬ 
elled  and  the  scabs  or  crusts  began  to  scale  or  crumble  on  the  eighth  or  ninth  day  ;  and 
on  the  tenth  day  most  of  the  scabs  had  separated  and  fallen  off,  and  left  brown-colored 
depressions  in  the  skin.  These  discolored  depressions  remained  for  some  time,  and  were 
distinguished  by  a  tubucular  hardness.  They  finally,  however,  disappeared,  and  left  no 
traces  of  the  existence  of  the  malady.  The  patient,  through  the  whole  course  of  the 
disease,  suffered  but  little,  and  was  not,  for  a  single  day,  confined  to  her  bod.  The  febrile 
symptoms  subsided  on  the  breaking  out  of  the  eruption,  and  did  not  afterwards  reap¬ 
pear.  A  swelling  of  the  face  and  hands  took  place  during  maturation,  but  this  went  off 
as  soon  as  desiccation  commenced.* 

Figures  89  and  90,  Plate  21,  represents  varioloid  pock,  which  appeared  on  a  little  girl 
six  years  of  age.  Figure  89,  second  day  of  eruption.  Figure  90,  fourth  day  of  eruption. 
This  little  girl  had  been  vaccinated  when  an  infant,  and  the  vaccine  scab  was  strong! v 
marked  on  her  left  arm.  She  had  been  confined  to  the  sick  ward  in  the  Hdpital  des 
Enfans  Malades  of  Paris  in  the  summer  of  1826,  and  whilst  she  was  recovering  from  a 
slight  fever,  a  girl  fourteen  years  of  age  who  occupied  a  bed  near  to  the  one  she  lay  in, 
was  taken  sick  and  broke  out  with  the  confluent  small-pox.  Just  sixteen  days  from  the 
exposure  of  the  little  patient  to  this  case  of  confluent  small  pox,  about  twenty  pimples 
were  discovered  on  different  parts  of  her  body.  The  eruption  broke  out  without  any  or 
very  little  previous  illness,  which  would  not  have  been  noticed  had  it  not  been  succeeded 
by  the  eruption.  A  slight  degree  of  langour,  and  a  little  dizziness  and  pain  in  the  head, 
attended  with  a  partial  loss  of  appetite  was  all  the  symptoms  that  were  observed.  The 
eruption  first  showed  itself  on  the  upper  and  inner  part  of  the  thigh,  and  was  vesicular 
when  discovered.  A  few  pimples  were  next  seen  on  the  face,  trunk  and  hands,  and  were 
papular  on  their  arrival  at  the  surface,  but  before  the  termination  of  the  first  day  their 
tops  were  converted  into  regular  vesicles,  containing  a  light  straw-colored  serum.  On 
the  fourth  (Figure  90),  they  had  gained  their  full  size,  and  the  matter,  which  they  contained 
began  to  concrete  and  dry  up. 

On  the  sixth  day  the  virus  had  completely  dried  up,  and  the  surfaces  of  the  pocks  were 
covered  with  dry,  light  brown  scabs.  On  the  eighth  day  these  scales  or  scabs  had  become 
harder  and  of  a  darker  color  and  began  to  crumble  off.  During  the  march  of  the  erup¬ 
tion  the  patient  suffered  but  little  and  experienced  no  secondary  fever,  and  was  as  play¬ 
ful  and  lively  as  usual.  She  remained  during  all  this  time  in  the  ward  in  which  she  was 
taken  sick,  and  continued  to  sleep  in  the  same,  notwithstanding  the  one  next  to  it  was 
occupied  by  the  girl  who  was  sick  with  confluent  variola.  After  the  scabs  had  separated 
and  fallen,  purplish  depressions  or  marks  remained  in  the  skin  for  some  days,  but  then 
disappeared  by  degrees  and  in  three  weeks  every  vestige  of  the  pocks  had  disappeared. t 

Figure  87  and  Figure  88,  contain  an  accurate  copy  of  an  eruption  of  the  natural  small¬ 
pox,  as  it  appeared  on  the  hand  and  round  the  eye  of  a  laborer  on  the  seventh  day  after 
it  broke  out.  The  pustules  were  very  numerous  and  were  coherent  and  were  piled  upon 
each  other,  but  were  not  confluent,  and  had  passed  into  a  state  of  suppuration.  They 
were  perfectly  round  and  varied  in  sizein  the  different  regions  on  which  they  existed.  They 
were  much  larger  and  more  globular  on  the  hand  than  round  the  eye,  as  represented  in  i  lie 
figures.  •  On  the  hands  and  feet  the  pustules  were  of  the  tubucular  or  warty  kind,  and 
differed  from  those  of  the  face  and  trunk,  and  from  the  more  common  eruption,  in  being 
more  compact,  harder  and  less  prone  to  suppuration.  Every  part  of  the  body  of  this  pa¬ 
tient  was  nearly  as  thickly  studded  with  the  pustules,  as  the  regions  here  represented, 
and  tho  eyes  even  were  invaded  by  the  eruption,  and  the  sight  of  one  of  them,  as  shown 
in  Figure  87,  was  destroyed  by  a  pustule  which  appeared  over  the  pupil.t 

*Small-pox,  eto.,  John  D.  Fisher,  M.  £>.,  p.  35. 

fSmall-pox,  Fisher,  p.  37. 

fSmall-pox,  etc.,  by  John  D.  Fisher,  M.  I).,  Boston,  1834,  p,  42. 


238 


Malignant  Small-Pox. 


YAEIOLA  MALIGN  A — VARIOLA  HAEMORRHAGIC  A. 

This  fatal  variety  of  small-pox  was  called  by  the  early  writers  Variolm 
Nigrse.  The  blood  appears  to  be  poisoned  from  the  first  by  the  disease, 
being  rendered  florid  and  watery.  When  drawn  from  a  vein  a  large  part 
of  it  will  be  found  to  be  serum,  and  what  ought  to  be  the  crasamentum 
remains  almost  fluid  ;  it  is  principally  coloring  matter;  the  fibrin  seems  to 
have  disappeared.  The  countenance  of  the  patient  is  sunken,  the  breath¬ 
ing  anxious,  and  in  some  instances  death  takes  place  before  the  eruption 
lias  been  developed,  leaving  it  doubtful  whether  the  disease  was  small-pox, 
scarlet-fever,  or  some  other  form  of  idiopathic  malignant  fever.  The  erup¬ 
tion  is  rather  slowly  developed.  There  is  hemorrhage  from  some,  and 
occasionally  from  all,  or  nearly  all,  of  the  mucous  surfaces;  from  the  nose, 
from  the  mouth,  from  the  air  passages,  from  the  bowels,  from  the  uterus 
and  vagina.  In  the  female  there  is  invariably  hemorrhage  from  the  uterus 
and  abortion  in  cases  of  pregnancy,  and  the  foetus  is  usually  born  dead. 
Hemorrhage  frequently  occurs  from  the  kidneys,  and  the  urine  is  loaded 
with  blood.  Albumen  with  granular  casts  may  appear  in  non-malignant 
cases  of  small-pox,  but  the  presence  of  blood  in  the  urine  of  this  disease 
must  be  regarded  as  a  symptom  of  the  most  serious  import. 

A  patch  of  effused  blood  under  the  conjunctiva,  appearing  early  in  the 
attack,  should  always  be  looked  upon  as  a  most  dangerous  svmptom.  In 
some  instances  blood  oozes  from  the  ears  and  eyes.  Livid  patches  from 
effused  blood  are  formed  on  the  surface  of  the  body,  and  blood  is  mixed 
with  the  fluid  formed  in  the  small-pox  vesicles  which  can  scarcely  be  said 
to  become  pustules.  There  is  great  depression,  but  the  intellect  usually 
remains  clear  to  the  last  without  delirium.  A  confluent  eruption  generally 
accompanies  the  malignant  form  of  small-pox,  and  death  commonly  takes 
place  on  the  fifth  day  of  the  eruption. 

Petechial  small-pox  presents  very  nearly  the  same  characters  as  malig¬ 
nant  small  pox;  the  condition  of  the  blood  is  very  much  the  same  in  these 
two  varieties  of  the  disease.  In  Petechial  small  pox  numerous  little  dark 
spots,  resembling  flea-bites,  especially  about  the  arm-pits  and  groins,  are 
observable,  and  the  skin  in  these  parts  has  a  greenish-yellow  hue,  very  like 
what  is  seen  around  a  severe  bruise. 


DEVELOPMENT  AND  STRUCTURE  OE  THE  SMALL-POX  PUS. 

TULE. 

The  eruption  or  formation  of  the  small-pox  pustule  has  certain  definite 
stages  in  its  development;  it  runs  a  given  course  ot  about  eleven  days,  and 
its  progress  undergoes  many  mutations ;  it  is  at  first  a  papule,  then  a 
vesicle,  then  a  pustule,  and  lastly  it  forms  a  scab  or  crust.  The  various 
changes  form  so  many  stadia  ot  unequal  duration. 

The  first  or  stage  of  papule,  lasts  from  twenty-four  to  twenty-eight  hours. 

The  secoud  or  vesicular  stage  lasts  four  days. 

The  last  stage,  or  that  of  scabbing ,  lasts  three  days  more ,  making  the  whole 
duration  of  the  normal  pustule  ten  or  eleven  days. 

There  are  varieties,  however,  of  small  pox,  in  which  the  formation  of 
the  pustule  is  irregular,  as  in  the  Hemorrhagic,  confluent  and  home  small¬ 
pox.  In  the  home  small-pox  the  two  last  stages  are  singularly  shortened 
or  absent  altogether. 

When  the  eruption  of  small-pox  is  of  the  distinct  variety ,  its  first  appear¬ 
ance  consists  of  a  number  of  small  red  papules,  about  the  size  of  a  pin’s 
head,  more  or  less  numerous,  but  separate  and  distinct  from  one  another, 


PLATE  21 


VARIOLOID  AATD  VARIOLA. 


Fig.  86/  Varioloid.  Fig.  87/  Small-Pox  erup- 
Figure  86.  tion.  Fig.  88/  Small-Pox  eruption. 

/  Fig.  89/  Varioloid  eruption.  Fig. 

y  .  90.*  Varioloid  eruption. 


\ 


TH1N6  W  OAltANS  LITH  10  UNION  ST 


* 


Structure  of  Small-Pox  Pustule. 


239 


and  scarcely  salient.  They  commence  with  a  circumscribed  hyperaemia  of 
the  true  skin,  extending  into  the  subcutaneous  tissue.  The  cells  of  the 
Pete  Malpighii  swell  up  the  papillae  elongate,  and  the  red  spot  of  skin  be¬ 
comes  a  sharply- defined  nodule,  perfectly  solid,  and  having  a  flattened  top. 

On  the  second  or  third  day  of  the  eruption,  the  second  stage  towards  the 
development  of  pustules  commences.  A  small  vesicle,  which  gradually 
enlarges,  bound  down  and  depressed  in  the  centre,  or  umbilicated ,  forms  on 
the  apex  of  each  pimple,  by  elevation  of  the  outer  layer  of  the  epidermis, 
and  contains  a  clear  whey-colored  fluid.  This  vesicular  stage  lasts  almost 
four  days,  when  the  vesicle  maturates  or  u  ripens  ”  into  a  pustule.  This 
process  is  so  gradual,  that  if  the  pustule  be  examined  closely  about  the 
fifth  or  sixth  day,  a  central  whitish  disc  of  lymph  may  be  seen,  set  in  or 
surrounded  by  a  circle  of  yebowish,  puriform  matter.  According  to  the 
testimony  of  Watson  and  others,  there  is  in  the  centre  a  vesicle ,  which  is 
distinct  from  the  pus,  so  that  you  may  puncture  the  vesicular  portion  and 
empty  the  contents  without  letting  out  any  of  the  pus  ;  or  you  may  punc¬ 
ture  the  part  containing  the  pus,  and  let  that  out  without  evacuating  the 
contents  of  the  vesicle.  The  vesicles  have  even,  by  careful  dissection,  been 
taken  out  entire.  The  pus  cells  form  from  the  young  cells  of  the  Pete  Mal¬ 
pighii.  The  adherence  of  the  altered  cuticle  to  the  cutis  at  some  points, 
and  its  separation  at  others,  produces  the  little  compartments  or  dissepi¬ 
ments  spoken  of  by  some  writers.  These  cavities  are  usually  irregular  in 
shape,  and  contain  a  white  substance  of  the  consistence  of  pulp  or  thick 
mucous,  which  at  first  was  supposed  to  be  the  specific  exudation  of  small¬ 
pox.  It  is  now  ascertained  that  it  is  no  pseudo  membrane,  but  is  composed 
of  the  deeper  and  softened  layers  of  the  epidermis.  This  u  disc”  ot  soft¬ 
ened  epidermis  covers  the  interior  of  the  pustule,  and  extends  from  the 
centre  to  the  raised  circumference  of  the  pustule  in  diverging  rays,  form¬ 
ing  part  of  six  or  eight  fan-like  chambers  of  nearly  equal  size.  In  the 
structure  of  this  disc  the  following  elements  are  distinguishable  from 
without  inwards :  (1),  large  flat  cells  ;  (2),  large  cells  not  so  flat, but  more 

globular  and  mucous ;  (3),  nearest  the  cutis  are  the  cells  and  tissue  of  the 
rete  mucosum.  (Gruby,  Gluge,  Kayer,  Gustav  Simon,  and  other  observers 
and  systematic  writers,  as  William  Aitken.) 

The  variolous  pock  has  been  carefully  examined  with  a  view  of  describ¬ 
ing  its  structure,  by  John  Hunter,  Dr.  Adams,  Petzholdt,  Erasmus  Wil¬ 
son,  Dr.  Gustav  Simon,  Sir  Thomas  Watson,  Dr.  Heming,  and  others ;  but 
it  would  be  foreign  to  our  purpose  to  present  an  extended  view  of  the 
opinions  of  these  various  writers,  and  the  above  concise  statements  of  the 
condition  of  our  knowledge  on  this  subject  will  be  still  further  illustrated 
by  the  following  description,  by  Carl  Wedl,  in  his  Rudiments  of  Pathologi¬ 
cal  Histology.* 

“External  integuments — exudations  in  this  situation,  are  particularly  fitted  for  study, 
being  accessible  to  observation,  even  during  life.  The  most  frequent  are  those  which 
take  place  in  the  cutaneous  papillae,  in  which  they  are  either  confined  to  small  limited 
districts,  in  which  the  exudation  takes  place  around  isolated  groups  of  papillae.  <>r  are 
more  extensive.  An  instance  of  the  former  kind,  or  of  a  limited  exudation,  is  afforded 
in  small-pox,  in  which  the  spots  are  at  first  filled  with  a  limpid  fluid,  containing  nothing 
but  molecules,  and  do  not  become  pustules  till  afterwards,  when  pus-corpuscles  are  de¬ 
veloped  in  the  hyaline  exudation.  The  transudation  takes  place  from  tbe  capillary  sys¬ 
tem  of-  the  papilloe,  the  exudation  as  it  is  poured  out  gradually  accumulating  between  the 
under  surface  of  the epidermis  and  the  upper  surface  of  the  corium.  Bur  since  the  pro¬ 
cess  is  confined  to  limited  groups  of  papilla; ,  the  epidermis  covering  the  latter  is  raised  in 
tbe  form  of  a  transparent  vesicle,  while  the  spot  at  which  the  hair  esca  pes  from  its  sheath, 
together  with  the  excretory  duet  of  the  sebaceous  follicle,  remains  depressed,  and  con¬ 
stitutes  the  central  pit  of  the  vesicle.  In  those  parts  of  the  skin  where  no  hair  or  seba- 


*Trauslatcd  by  George  Busk,  F.  K.  S. ;  Sydeubaiu  Society,  p.  206. 


240 


Changes  of  Temperature  in  Small-Vox. 


ceous  follicles  exist,  as  in  tlie  palm  of  the  hand  and  sole  of  the  foot,  the  exudation  de¬ 
posited  around  a  point  where  several  of  the  deeper  grooves  in  the  corium,  meet,  may  cause 
a  similar  pit, since  in  a  situation  of  this  kind  the  epidermis  constitutes  a  stronger  layer  and 
is  of  closer  texture.  When  the  puriform  fluid  in  the  pustules  begin  to  dry  up,  the 
pit  becomes  shallower  and  wider,  owing  to  the  subsidence  of  the  swelling.  In  the  integu¬ 
ments  of  a  subject  dead  of  small-pox,  it  is  easy  to  perceive  that  the  vessels  of  the 
papillae  are  more  or  less  injected,  when  the  skin  has  been  macerated  long  enough  to  allow 
of  the  removal  of  the  epidermis,  beneath  which  the  isolated  patches  of  vascular  injection 
are  immediately  apparent.  Perpendicular  sections  show  that  the  pajrillcv  are  the  con¬ 
stant  and  principal  seat  of  the  injection,  and  it  is  from  these  vessels  that  the  hemor¬ 
rhage  takes  place,  in  cases  of  petechial  small-pox.” 

The  poison  of  small-pox  is  believed  to  be  most  active  just  at  the  period 
when  the  clear  contents  of  the  vesicles  begin  to  turn  cloudy.  While  the 
maturation  of  the  vesicle,  into  a  pustule  is  going  on,  a  damask  red  areola 
forms  around  each  pustule;  and  as  the  vesicle  tills,  the  whole  face  swells, 
and  often  to  so  great  a  degree  that  the  eyelids  are  closed.  When  the  erup¬ 
tion  is  completed  the  “bridle”  which  bound  down  the  centre  of  the  vesicle, 
ruptures,  and  the  pustule  now  becomes  spheroidal  or  accumulated.  About 
the  eighth  day  of  the  eruption  a  dark  spot  is  seen  on  the  top  of  each  pustule. 
At  that  spot  the  cuticle  ruptures,  allowing  matter  to  exude,  which  conceretes 
into  a  scab  or  crust;  and  during  this  process  the  pustule  shrivels  and  dries 
up.  The  crust  is  detached  between  the  eleventh  and  fourteenth  days,  leav- 
the  cutis  beneath  of  a  dark  reddish  brown  hue,  a  discoloration  which  lasts 
many  days,  or  even  weeks.  On  the  face,  however,  the  pustule  often  pene¬ 
trates  or  burrows,  so  as  to  cause  ulceration  of  the  rete  mucosum ,  leaving  a 
permanent  cicatrix  in  the  form  of  a  depression  or  “pit.”  The  cicatrix  thus 
formed,  though  at  first  of  a  dark  reddish  brown,  ultimately  becomes  of  a  dead 
white  color. 

The  small  pox  eruption  does  not  appear  on  tlie  whole  body  at  once,  but 
appears  in  three  successive  crops.  The  first  crop  covers  the  face,  neck  and 
upper,  extremities ;  the  second  the  trunk,  while  the  third  appears  on  the 
lower  extremities.  There  is  usually  an  interval  of  several  hours  between 
each  crop ;  and  the  later  the  papules  are  in  appearing  on  the  trunk  and 
lower  extremities  than  on  the  face  and  neck,  by  so  much  the  later  they  are 
in  maturing  and  disappearing  from  these  parts.  When  the  eruption  on  the 
face  is  declining,  that  upon  the  extremities  has  scarcely  yet  arrived  at  its 
height,  so  that  the  hands  and  feet  are  then  considerably  swollen.  This  is 
to  be  regarded  as  a  favorable  sign,  in  so  far  as  it  indicates  a  certain  sign 
of  constitution. 

The  number  of  pustules  sometimes  does  not  exceed  five  or  six  over  the 
whole  body  ;  more  commonly  they  number  from  one  to  300,  and  occasion¬ 
ally  amount  to  several  thousands.  It  has  been  calculated  that  if  10,000 
pustules  be  counted  on  the  body  that  2000,  at  least,  will  be  found  on  the 
face;  and  accordingly  the  number  of  the  pustules  on  the  face  being  in 
proportion,  those  on  the  other  parts  of  the  body  furnish  a  fair  estimate  of 
the  extent  of  the  disease  and  of  the  danger  of  the  patient.* 


CHANGES  OE  THE  TEMPERATURE  AND  URINE  IN  SMALL¬ 
POX  (VARIOLA)  AND  IN  MODIFIED  SMALL-POX  VARIO¬ 
LOID. 

The  following  observations  and  chemical  researches  were  made  by  the 
author,  chiefly  during  the  recent  Civil  War  (1861-1865),  when  the  camp 
life  permitted  isolation  and  continuous  labor,  without  the  interruptions 
attending  private  practice. 


*  The  Science  and  Practice  of  Medicine.  By  William  Aitken,  M.  D,,  Edinb.,  Prof,  of  Pathology  in  the 
Army  Medical  School.  Philadelphia,  1872.  Vol.  1,  pp.  376-378. 


Changes  of  Temperature  in  'Small-Pox. 


241 


CHANGES  OF  TEMPERATURE  IN  SMALLPOX. 

The  fever  of  this  disease,  as  well  as  that  of  measles,  scarlatina,  typhus 
and  typhoid  fevers,  in  like  manner  with  those  of  hospital  gangrene  and 
surgical  fever,  is  due  to  the  contamination  of  the  blood  by  a  specific  organic 
poison. 

The  matinal  producing  small-pox  being  definitely  related  chemically  and 
physiologically  to  the  organic  constituents  of  the  living  body,  the 
development  of  the  disease  is  traceable  through  well  marked  stages. 

During  the  period  of  incubation  (the  duration  of  which  varies  within 
narrow  limits,  according  as  the  poison  has  been  introduced  by  the  mucous 
or  cutaneous  tissues,  in  the  former  case,  or  natural  small-pox,  the  period 
of  latency  varying  from  ten  to  fifteen  days,  and  in  the  small-pox  produced 
by  inoculation,  from  seven  to  nine  days),  the  specific  poison  absorbed 
gradually  infects  the  blood,  rendering  it  contagious  in  its  properties,  and 
excitant  and  irritant  to  the  nervous  system  and  circulatory  apparatus. 

The  infection  and  alteration  of  the  blood  during  the  period  of  inocula 
tion  in  small-pox  gives  rise  to  the  secondary  stage  of  primary  fever,  last-- 
ing  from  two  to  six  days,  till  the  eruption  appears,  when,  in  most  cases,  it 
remits.  This  stage  is  characterized  by  fever,  the  temperature  of  the  axilla 
rising  to  106°  F.  and  even  higher;  severe  muscular  pains,  especially  in  the 
small  of  the  back ;  nausea  and  in  some  cases  obstinate  vomiting,  oppres¬ 
sion  of  the  brain,  drowsiness,  stupor  and  even  coma,  and  occasionally  con¬ 
vulsions. 

During  the  fever  and  prior  to  the  appearance  of  the  eruption,  the  in¬ 
tense  pain  in  the  back  is  a  symptom  of  great  importance  as  giving  a  warn¬ 
ing  as  to  the  character  of  the  disease.  The  pain  in  the  back  is  a  peculiar 
and  striking  symptom,  and  is  more  intense  than  in  any  other  form  of  fever. 
It  is  distinguished  from  lumbago  by  its  position;  that  in  lumbago  affects 
the  muscles  on  each  side  of  the  spine,  and  is  greatly  aggravated  by  move¬ 
ment  ;  while  the  pain  of  the  back  in  small-pox  is  in  the  central  part  of  the 
sacrum  and  the  lumbar  region,  and  is  not  influenced  by  movement. 

During  a  series  of  investigations  and  post-mortems  on  small  pox  in 
1864,  I  suffered  with  all  the  symptoms  of  the  first  stages  of  this  disease,  and 
experienced  the  most  intense  pain  in  the  back;  this  pain  was  even  greater 
than  that  which  I  suffered  subsequently  in  1873  from  dangue,  and  in  1878 
from  yellow  fever. 

Three  views  have  been  advanced,  as  to  the  source  of  this  characteristic 
pain  in  small -pox. 

(1.)  Hypermmia  of  the  spinal  medulla. 

(2.)  Pressure  on  spinal  nerves  as  they  emerge  from  the  lumbar  and  sacral 
regions  by  the  distended  venous  plexus  surrounding  them  in  the  bony  out¬ 
lets. 

(3.)  Excessive  hypersemia  of  the  kidney,  or  incipient  nephritis  in  the 
connective  tissues  of  the  kidney. 

In  severe  cases  of  small-pox  I  have  detected  albumen  and  urinary  casts 
in  the  urine,  and  the  pain  may,  in  some  degree,  be  due  to  hypersemia  of 
these  organs,  but  is  most  probably  referable  to  congestion  of  the  spimq 
cord. 

On  the  evening  of  third  or  morning  of  the  fourth  day,  after  the  com¬ 
mencing  of  chill,  the  fever  is  usually  at  its  height ;  and  on  the  fourth  day, 
sometimes  sooner  and  but  seldom  later,  the  eruption  appears,  and  the 
third  stage  commences,  the  phenomena  of  the  third  stage  are  as  a  calm 
succeeding  to  a  storm  ;  for  on  the  appearance  of  the  eruption,  the  fever  re¬ 
mits,  the  heat  abates,  the  affection  of  the  head  subsides,  the  vomiting 


242 


Changes  of  Temperature  in  Small-Pox. 


ceases,  and  the  pulse  returns  to  its  natural  standard.  The  febrile  phe' 
nonrena  seem  to  have  altogether  disappeared  for  the  time,  and  the  patient 
may  think  himself  well.  A  temporary  defervescence  is  thus  well  marked, 
the  temperature  falling  from,  perhaps,  106°  F.  progressively  downward  to 
100°  F. 

Ou  the  first  or  second  day  of  the  disease  the  temperature  may  attain  a 
considerable  height,  seldom  below  40°c  (104°F.),  and  more  often  above  it; 
and  this  rise  may  occur  in  an  unbroken  liue  and  with  extreme  rapidity,  or 
it  may  occur  more  slowly  and  reach  the  elevation  on  the  second  evening. 
On  the  second  day  the  temperature  may  have  already  attained  its  maxi¬ 
mum,  or  may  still  exhibit  a  moderate  increase  on  the  third  or  on  the  fourth 
day,  with  which  only  very  slight  remissions  occur  in  the  morning  hours. 

According  to  Dr.  C.  A.  Wunderlich  :* 

“  The  maximum  temperature  of  the  initial  stage  or  prodromal  fever  is  only  exceptionally 
less  than  40°c  (104°F. ),  generally  somewhat  above  that,  sometimes  even  41°c  (105. 8°F.), 
or  indeed  a  few  tenths  more. 

“When  the  maximum  has  been  reached  a  slight  fall  immediately  ensues,  which  gen¬ 
erally  lasts  only  one  day.  At  this  time  we  may  commonly  notice  the  first  traces  of  the 
eruption  in  the  form  of  spots.  This  stage  lasts  from  two  to  five  days,  and  it  is  not  pos¬ 
sible  at  this  time,  from  the  course  of  the  temperature,  to  discriminate  small-pox  from 
exanthematus  typhus,  relapsing  fever,  or  from  a  pneumonia  which  as  yet  affords  no  local 
evidence  of  its  presence;  and  even  when  the  other  symptoms  are  taken  in  conjunction, 
it  is  seldom  that  we  can  speak  with  complete  certainty.  Yet,  on  the  one  hand,  every  day 
that  the  fever  lasts,  without  the  lung  symptoms  render  pneumonia  less  probable;  and, 
on  the  other  hand,  if  the  fifth  day  of  the  disease  pass  over  without  any  eruption  making 
its  appearance,  the  presence  of  small-pox  must  be  cousidered  very  doubtful. 

“  Soon  after  the  first  development  of  the  variolous  papules,  the  temperature  falls  more  or 
less  rapidly.  In  rare  cases  of  the  disease  this  defervescence  occurs  as  early  as  the  second  or 
third  day  of  the  disease,  but  generally  from  the  fourth  to  the  seventh  day.  The  downfall 
lasts  only  twenty-four  hours  or  less,  in  which  case  it  is  continuous;  or  two,  or,  indeed, 
even  three  days,  when  it  is  generally  not  continuous,  or,  in  other  words,  it  is  interrupted 
by  a  moderate  evening  exacubation.  *  *  * 

“The  falling  temperature  after  the  prodromal  stage  either  never  gets  down  to  normal, 
sometimes  remaining  sub-febrile,  but  generally  at  decided  febrile  degrees,  and  continuing 
in  this  fashion  for  several  days,  with  or  without  daily  fluctuations;  or  tbe  normal  tem¬ 
perature  is  reached,  if  at  all,  tediously,  and  deffervescence  is  by  lysis.” 

About  the  fourth  day  of  the  eruption,  and  about  the  eighth  day  of  the 
disease,  inclusive,  from  the  first  attack  of  the  primary  fever,  when  the 
eruption  is  fully  out,  and  the  most  advanced  pustules  commence  to  matur¬ 
ate,  the  commencement  of  suppuration  is  announced  by  the  swelling  of  the 
integument,  and  especially  of  the  whole  face,  head  and  neck.  During  this 
period  of  intumescence  (generally  lasting  three  days),  simultaneously  with 
the  renewed  hyperamia  of  the  skin,  and  introductory  to  the  change  taking 
place  in  the  cavity  of  the  pustules,  the  fever,  which  had  remitted,  returns, 
and  the  last  stage,  or  that  of  secondary  or  suppurative  fever,  commences. 
In  rare  cases  of  extraordinary  interest,  this  stage  is  marked  by  a  rise  of  tem¬ 
perature  to  a  considerable  height  (104°,  105°,  and  even  in  the  case  of  Colonel 
Nat.  Offut,  my  hospital  student,  to  lll°c,)  by  acceleration  of  the  circula¬ 
tion,  and  by  slight  delirium  and  rigors.  In  cases  of  greater  intensity, 
severe  delirium,  a  harsh,  dry,  cough,  and  hemorrhages  from  the  kidneys  and 
lungs  and  bowels  may  be  added  to  the  other  symptoms. 

In  many  cases  the  secondary  fever,  and  the  swelling  and  redness  of  the 
face,  having  lasted  from  three  to  five  days,  subside,  and  the  now  fully  ripe 
pustules  burst  and  discharge  a  thin,  yellow  matter,  which  concreting  into 
a  crust,  falls  off  on  the  fourteenth  or  fifteenth  day,  and  the  disease  terminates. 
During  these  changes  the  secondary  fever  of  small-pox  disappears,  and 
the  temperature  sinks  gradually  to  the  normal  standard. 


*On  tbe  Temperature  in  Disease  ;  Sydenham  Society*!  London,  1871;  p.  339. 


Changes  of  Temperature  in  Small- Pox. 


243 


The  secondary  fever  of  small-pox  is  clearly  related  to  the  suppurative  process, 
and  without  doubt  has  much  the  same  origin  as  uncomplicated  inflammatory 
fever  accompanying  mechanical  injury  or  amputation,  or  suppurative  inflam¬ 
mation  of  some  important  organ.  It  is  mainly  due  to  the  absorption  of  the 
serum  of  the  pus,  and  of  the  products  of  the  inflammatory  exudations. 

In  many  cases  the  secondary  (suppurating)  fever  is  of  indefinite  dura¬ 
tion,  varying  in  accordance  with  the  intensity  of  the  disease  ;  and  at  the 
same  time  its  course  and  the  height  of  the  temperature  differ  according  to 
the  danger  and  severity  of  the  disease.  In  small  pox  of  moderate  severity 
the  temperature  in  this  stage  scarcely  reaches  39°c  (102.2°  F.)  in  general, 
and  very  rarely  40°c  104°F.)  or  more;  there  are  morning  remissions,  and 
the  duration  is  usually  only  a  few  days.  In  some  cases  the  temperature  is 
considerably  higher;  the  course  is»  sometimes  remittent,  with  very  marked 
exacerbations. and  sometimes  continuous  with  occasional  isolated  elevations 
of  temperature. 

Irregular  fluctuations  very  often  mark  its  course.  If,  during  the  fever 
of  suppuration,  the  temperature  several  times  exceeds  40°c  (104°F.),  it  is  a 
sign  of  great  danger.  In  cases  not  fatal  the  duration  of  the  secondary 
fever  is  seldom  less  than  a  week. 

In  favorable  cases  the  fever  depresses  by  lysis,  in  a  very  gradual  man¬ 
ner,  and  sometimes  at  the  time  of  scabbing,  there  is  an  occasional  preju¬ 
dicial  but  brief  rise  of  temperature,  or  the  fever  may  even  continue  till 
desiccation,  and  it  may  even  be  longer. 

In  fatal  cases,  the  temperature  may  rise  rather  quickly  ,  from  mod¬ 
erate  heights  to  very  considerable  degrees,  and  death  may  occur  at  42°  c. 
(107.6°  F. ) ,  or  even  more,  although  during  this  stage  the  patient  may  die 
with  only  moderate  elevation  of  temperature.  Simon  ( Charite  Annative, 
13,  Bd.  5)  has  published  cases  in  which  the  temperature  ('which  was,  how¬ 
ever,  measured  after  death )  was  43.75°  and  44.5°  c.,  respectively,  (110.75° 
and  112.1°;. 

Serious  complications  may  cause  intercurrent  attacks  and  irregularities 
in  the  temperature,  which,  however,  presents  nothing  specially  character¬ 
istic  of  small-pox.* 


CHANGES  OF  THE  TEMPERATURE  IN  VARIOLOID  OR  MODI- 
“FIED  SMALL  POX  (SMALL  POX  AFTER  VACCINATION). 

Small-pox  as  modified  by  vaccination,  received  the  name  of  Vamoloid, 
first  suggested  for  it  by  Dr.  John  Thompson,  of  Edinburgh,  who  wrote  a 
work  ou  the  subject  in  1820;  and  this  word  has  been  adopted  generally  in 
Europe  and  America  by  writers  on  small-pox. 

Small-pox  after  vaccination  presents  various  degrees  of  severity,  and 
modification,  from  the  slightest  form  of  which  there  is  none,  or  hardly 
any  eruption  at  all,  to  the  most  confluent  cases,  closely,  often  exactly 
resembling  the  disease  in'  the  unvaccinated  ;  and  it  also  assumes  the 
petechial  and  malignant  types  after  vaccination  just  as  in  the  unvac- 
einated  state.  This  depends  in  a  large  measure  upon  : 

*  Investigations  upon  the  Nature.  Causes,  and  Treatment  of  Hospital  Gangrene,  as  it  prevailed  in  the 
Confederate  Armies,  1861  1865;  by  Joseph  Jones,  M  I).  Surgical  Memoirs  United  States  Sanitary  loin- 
mission  ;  New  York.  1871,  pp,  355-361. 

C.  A.  Wunderlich  ;  A  rc.hiv  fur  physiol,  Heilkunde,  N.  F.  2,  18.  1858.  Leo;  Archiv  der  Heilkunde,  4, 
481,1864;  Frohlich,  ibid,  1867,  v.  8.  420;  Korber,  Petersb  Zeitschrift,  13,  303  On  the  Temperature  in  Dis- 
eases  ;  a  Manual  of  Medical  Thermometry,  by  Dr.  C.  A.  Wunderlich,  New  Sydenham  Society;  1871,. 
pp  337-341.  table  4.  The  Science  and  Practice  of  Medicine,  by  William  Aitkin  ;  Philadelphia,  1872,  vol.  1, 
pp.  376-398. 


244 


Changes  of  Temperature  in  Varioloid  or  Modified  Small-Pox. 


1.  The  matter  with  which  the  patient  has  been  vaccinated. 

2.  The  mode  in  which  the  vaccination  has  been  performed. 

3.  The  length  of  time  which  has  elapsed  since  the  performance  of  the 
vaccination. 

4.  The  state  of  the  constitution  of  the  patient  at  the  time  of  the  erup¬ 
tion  of  the  variolous  poison. 

Dr.  J.  F.  Marson,  Resident  Surgeon  to  the  London  Small-l:>ox  Hospital, 
has  published  the  following  valuable  table,  illustrating  the  effects  of  the 
mode  of  vaccination  upon  the  subsequent  attacks  of  small-pox  (varioloid) : 

TABLE. 


Analysis  of  all  ihe  Cases  of  Small-pox  after  Vaccination,  admitted  at  the  Small-pox  and 
Vaccination  Hospital,  London,  for  a  period  of  twenty  years,  viz:  from  1836  to  1855,  in¬ 
clusive,  showing,  from  a  careful  examination  of  the  Cicatrices,  the  relative  amount  of  secu¬ 
rity  given  by  the  number  of  Vesicles  produced  at  Vaccination  ;  and,  judging  from  the  char¬ 
acter  of  the  Cicatrices,  the  probable  state  of  activity  and  efficiency  of  Lymph  used  after 
Vaccination. 


Number  of  Patients 

Character  of 

Cicatrices. 

Cases. 

Good . 

1,032 

Indifferent 

969 

Good. 

873 

Indifferent. 

573 

Good. 

307 

Indifferent. 

211 

Good. 

358 

Indifferent. 

180 

370 

370 

17 

17 

4,896 

4,896 

PATIENTS  ADMITTED  WITH 
SMALL-POX. 


1.  Having  one  vaccine  cicatrix  . ^ 

2.  Having  two  vaccine  cicatrices  . J 

3 .  Having  three  or  more  vaccine  cicaitrices _ ^ 

4.  Having  four  or  more  vaccine  cicatrices  <j 

5.  Stated  to  have  been  vaccinated  hut  hav-( 

ingno  cicatrix  . .  .  .  . ) 

5.  Stated  to  have  been  vaccinated  hut  par-( 
ticulars  of  cicatrix  not  recorded . ) 


Total . .  4,896 


RESULTS. 


Discharged. 

1 

<D 

s 

Died  Affected  by 
Super  added 
Diseases. 

978 

54 

15 

835 

134 

21 

841 

32 

12 

516 

57 

10 

300 

7 

4 

202 

9 

2 

356 

2 

0 

183 

3 

2 

269 

101 

18 

14 

3 

4,494 

402 

86 

Ratio  per  cent 
of  Mortality 
from  Smalf- 
Pox, after  de¬ 
ducting  en¬ 
tirely  Cases 
affected  by 
Super  added 
Diseases. 


3.83  l 
11.91  3 
2  32  \ 
8.34  5 
0.99  } 
3.343 
0.55  l 
0.54  3 


7.73 

4.70 

1.95 

0.55 

23.57 

6.66 


6.56 


Dr.  Marson  describes  a  good  vaccine  cicatrix  as  distinct,  foveated, 
dotted,  or  indented,  in  some  instances  radiated,  and  having  a  well,  or  toler¬ 
ably  well-defined  edge;  an  indifferent  cicatrix  is  indistinct,  smooth,  with¬ 
out  indentation,  and  with  an  irregular,  well-aefined  edge. 

According  to  the  preceding  statistics,  and  in  accordance  with  the  valua¬ 
ble  experience  of  Dr.  Marson,  the  aggregate  mortality  with  good  vaccine 
cicatrices,  from  small-pox  alone,  uninfluenced  by  other  diseases,  is  2.25  per 
cent. ;  with  indifferent  vaccine  cicatrices,  from  small  pox  alone,  uninfluenced 
by  other  diseases,  8.82  per  cent. 

There  is  found  to  be  a  mortality  of  about  two  per  cent,  in  vaccinated  as 
well  as  unvaccinated  patients  from  small-pox,  being  complicated  with  ante¬ 
cedent  or  superadded  diseases. 

Three-fourths  of  the  cases  had  taken  the  vaccination  in  but  one  or  two 
places,  and  among  these,  by  far  the  largest  proportionate  mortality  from 
small-pox  has  fallen.  By  vaccinating  so  as  to  take  effect  in  four  or  more 
places,  we  not  only  save  life,  but  prevent  a  great  deal  of  suffering  and  sub¬ 
sequent  damage  to  the  appearance  of  the  person,  which,  in  females  at  least, 
is  of  great  consequence,  and  not  always  quite  a  matter  of  indifference  to 
males. 


Changes  of  Temperature  in  Varioloid  or  Modified  Small-Pox.  245 
______ _ • _ _ _ * _ _ _ 

Of  544  cases  having  four  or  more  vaccine  cicatrices,  not  one-half  of  one 
per  cent,  died  of  small  pox,  or  one  in  200;.  whereas  of  969  cases,  with  only 
one  indifferent  vaccine  cicatrix,  almost  twelve  per  cent.  died. 

Of  <70  persons  who  believed  themselves  vaccinated,  but  who  had  no  cic¬ 
atrix  to  show  for  having  been  vaccinated,  but  who  trusted  to  it  for  their 
protection,  died  of  small-pox  at  the  rate  of  twenty-three  and  one-half  per 
cent. 

The  security  of  vaccinated  persons  gradually  rises,  not  only  from  the 
number  of  cicatrices  produced  at  vaccination,  but  also  according  to  the 
quality  of  the  cicatrices.  Active  vaccine  lymph,  such  as  leaves  clear,  per¬ 
manent  cicatrices,  is  evidently  indicated  as  the  most  desirable  to  select  for 
use  in  vaccination. 

According  to  Dr.  J.  F.  Marson,  “In  the  course  of  years  vaccine  lymph 
becomes  humanized,  by  passing  many  times  through  the  subject,  and  can 
only  be  kept  in  a  great  state  of  efficiency  by  having  many  subjects  con¬ 
stantly  to  select  from  for  its  continuance,  and  even  then  the  cicatrices  it 
leaves,  after  many  years’  use,  are  not  so  good  as  they  were  formerly. 

“Out  of  large  numbers  ot  cases  'of  small-pox  after  vaccination,  viz., 
1,958,  admitted  into  the  Small-pox  Hospital  during  the  years  1863  and  ’64 — 
small-pox  having  been  epidemic  in  London  throughout  these  entire  years — 
the  mortality  shows  a  considerable  increase,  by  from  6.56  per  cent,  for 
twenty  years — 1836  to  1855— to  a  mortality  of  9.2  per  cent,  out  of  1,958 
cases  for  the  years  1863  and ’64;  all  patients  manifesting  antecedent  or 
supervening  diseases  having  been  deducted  from  the  calculation. 

“It  is  a  question  that  may  be  fairly  and  properly  entertained,  and  de¬ 
serves  very  mature  deliberation,  whether  we  ought  not  to  resort  more  fre¬ 
quently  than  has  hitherto  been  done  to  supplies  of  lymph  from  the  eow.”# 

Modified  small-pox,  or  varioloid,  is  characterized  by  the  comparative 
mildness  of  the  symptoms,  the  pustules  being  cut  short  in  their  develop¬ 
ment  by  vaccination  or  a  primary  attack  of  small-pox. 

The  principal  varieties  of  modified  small-pox  (varioloid)  have  been  thus 
classified  by  systematic  nosologists : 

1.  A  fever  of  three  days,  without  eruption,  affecting  people  during  va¬ 
riolous  epidemics  ( variolae  sine  variolis  vel  eruptione). 

2.  A  high  and  severe  fever,  followed  by  a  very  mild  eruption,  sometimes 
only  a  single  pock;  the  slight  proportion  which  the  amount  of  eruption 
bears  to  the  severity  of  the  preceding  fever  is  perhaps  the  most  marked 
characteristic  of  varioloid. 

3.  The  occasional  appearance  of  a  scarlet  efflorescence,  like  that  of 
scarlatina  or  roseola,  preceding  the  appearance  of  the  proper  pimples, 
which  occur  as  a  very  scanty  crop. 

4.  In  some  rare  instances  the  eruption  is  confluent,  but  does  not  advance 
beyond  the  development  of  a  pimple  or  vesicle,  and  begins  to  dry  on  the 
fourth  or  fifth  day  of  the  eruption,  forming  a  small,  hard  tubercle,  which 
soon  disappears. 

5.  Sometimes  the  eruption  is  pimple,  vesicle  and  pustule  at  one  time  in 
the  same  case. 

6.  Sometimes  the  eruption  runs  its  regular  course,  but  stops  sooner, 
sometimes  on  the  sixth  or  seventh  day,  instead  of  the  eighth  or  ninth.  In 
general,  it  may  be  stated  that  the  severity  and  fully  developed  state  of  the 
disease  is  in  proportion  to  the  length  of  time  which  elapses  from  vaccination. 


*Small-pox,  J .  F  Marson ;  System  of  Medicine,  by  J.  Russell  Reynolds;  Philadelphia,  1879;  vol.  1,  pp. 


246  Changes  of  Temperature  in  Varioloid  or  Modified  Small-Pox. 


7.  The  varioloid  eruption  wants  the  peculiar  odor  of  natural  small-pox, 
and  secondary  fever  is  very  rare.* 

It  may  be  stated  in  general  terms  that  in  varioloid,  after  an  intense  con¬ 
tinuous  fever,  lasting  a  few  days,  a  final  exacerbation  terminates  the  fever 
suddenly  and  simultaneously,  with  the  development  of  the  small  pox  pim¬ 
ples.  A  rapid  and  perfect  defervescence  then  ensues,  the  temperature 
decreasing  seven  or  more  degrees,  Fahr.,  within  thirty-six  hours.  From 
this  event  the  patient  remains  entirely  free  from  fever — provided  there  exists 
no  serious  complication — in  spite  of  the  continuous  and  progressive  develop¬ 
ment  of  the  small-nox  pimples  into  pustules,  and  even  in  spite  of  the  suc¬ 
cessive  eruption  of  new  pimples. 

It  is  evident,  therefore,  that  the  fever  in  small-pox  exhibits  two  distinct 
types ,  which  closely  correspond  at  their  commencement. 

These  ttvo  types  correspond  to  the  two  chief  modifications  of  small-pox; 
one  a  brief  continuous  form,  belonging  to  modified  small-pox  or  varioloid , 
occurring  chiefly,  although  not  exclusively,  in  vaccinated  or  inoculated 
persons;  the  other  a  relapsing  type, which  characterizes  the  unmodified  small¬ 
pox  ( variola ,  vera) ,  which  runs  its  course  with  fever  in  the  suppurating 
stage. 

The  course  of  the  temperature  in  the  initial  stage  will  not  suffice  to  dis¬ 
tinguish  between  true  variola ■  and  varioloid,  but  as  soon  as  the  exanthem 
develops  itself  the  course  of  the  temperature  is  not  only  the  most  certain, 
but  the  only  certain,  criterion  by  which  true  small-pox  may  be  distin¬ 
guished  from  the  modified  form.  Not  only  in  the  occurrence  of  a  more  or 
less  developed  secondary  or  suppurative  fever  the  most  trustworthy  means 
of  diagnosis  between  the  two  fevers,  but  the  mode  of  defervescence  of  the 
eruptive  fever  gives  an  almost  infallible  indication  as  to  the  kind  of  further 
course  of  the  disease. 

The  initial  period  is  common  to  both  types  ( variola  and  varioloid ).  In 
the  first  or  second  days  of  the  disease  the  temperature  attains  a  considera¬ 
ble  height,  seldom  below  and  often  above  104°  F.;  the  maximum  tempera¬ 
ture  of  the  initial  stage  or  prodromial  fever  reaching  in  many  cases,  and 
even  exceeding,  106°  F. 

-  Soon  after  the  first  development  of  the  variolous  papules  the  temperature 
falls  more  or  less  rapidly. 

In  cases  of  uncomplicated  varioloid  the  temperature  quickly  reaches  by 
this  defervescence,  or  falls  down  a  trifle  below  it,  and  thenceforth  remains 
normal  or  pretty  nearly  so,  unless  the  occurrence  of  some  complication 
causes  a  fresh  rise,  which  is  but  seldom  the  case. 

When  the  eruption  in  modified  small-pox  ( varioloid )  is  very  copious 
there  may  sometimes  occur  a  slight  (scarcely  febrile)  and  seldom  febrile 
elevation  of  temperature  at  the  time  when  the  pustules  are  desiccating,  but 
this  does  not  last  long  in  any  case. 

This  fall  of  temperature  is  the  best  characteristic  of  varioloid,  especially 
when  regard  is  had  to  the  fact  that  the  defervesence  is  not  simultaneous 
with  the  full  development  of  the  eruption,  but  occurs  soon  after  that 
begins,  even  at  the  time  the  spots  begin  to  be  papular,  or  to  be  distinctly 
felt  as  elevations. 

CONSTITUTION  AND  CHANCES  OF  THE  URINE  IN  VARIO¬ 
LOID  (MODIFIED  SMALL-POX),  AND  IN  VARIOLA  VERA 
(SMALLPOX). 

The  urine  of  small-pox  presents  changes  corresponding,  to  a  certain  ex¬ 
tent,  with  the  four  well  marked  stages  of  the  disease. 


'Science  and  Practice  of  Medicine,  by  Willism  Aithen.  M.  D.;  Edinburgh;  Philadelphia,  1872;  vol 
1,  p.  368. 


Constitution  and  Changes  of  the  TJrine  in  Varioloid. 


247 


In  this  disease,  the  urinary  excretion  presents  uniform  characteristics ; 
namely,  great  concentration,  increase  of  the  urea  and  uric  acid,  phosphoric 
acid,  and  sulphuric  acids,  and  diminution  and  even  total  disappearance 
of  tlie  chloride  of  sodium. 

The  urine  of  modified  small-pox  ( varioloid ),  slso  presents  marked  differ¬ 
ences  from  that  of  true  uncomplicated  small  pox. 

The  table  contains  a  consolidated  statement  of  the  results  of  the  author’s 
labors  upon  the  changes  of  the  urine  in  varioloid  and  variola  during  the 
civil  war  (1861-1862,). 


\ 


* 


e 


248 


0 

Observations  upon  the  Constitution  of  XJrine  in  Small-Pox. 


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Observations  upon  the  Constitution  of  Urine  in  Small-Pox . 


249 


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250  Constitution  and  Changes  of  the  Urine  in  Varioloid  and  Small-Pox. 


When  it  is  considered  that  these  patients  partook  of  hut  little  food,  and 
were  in  a  state  of  almost  absolute  rest,  it  is  evident  that  the  urea  is  con¬ 
siderably  increased  in  the  urine  of  small-pox,  amounting’  in  one  case  to  over 
six  hundred  grains  during  the  twenty-four  hours.  As  a  general  rule,  the 
increments  of  this  constituent  corresponded  with  the  severity  of  the  dis¬ 
ease,  being  but  little  above  the  normal  standard  in  mild  cases  of  varioloid, 
and  increasing  to  double  and  even  treble  the  usual  amount  in  cases  of  con¬ 
fluent  small  pox.  In  like  manner,  the  uric  acid  and  the  phosphoric  and 
sulphuric  acids  were  increased.  The  excretion  of  these  constituents  furn¬ 
ishes  a  measure  of  the  destructive  metamorphosis  of  the  blood  and  muscu¬ 
lar  and  nervous  systems  during  the  progress  of  the  disease.  The  uric  acid 
and  urates  exist  in  such  large  amounts  in  the  concentrated  and  scant  urine 
of  small  pox  as  to  form  heavy  deposits  upon  cooling.  Uric  acid  is  in  like 
manner  largely  increased  in  hospital  gangrene;  and  this  increase,  as  in  the 
case  of  small-pox,  must  be  referred  to  the  derangement  of  the  nutrition, 
and  oxidization  of  the  nitrogenized  elements  and  constituents  and  tissues. 

The  great  concentration  of  the  urine  in  small-pox  may  be  due  to  several 
causes,  as  the  congestion  of  the  kidneys,  the  peculiar  constitution  of  the 
blood,  in  virtue  of  which  the  water  is  held  more  tenaciously  in  combination 
with  the  nitrogenized  elements  and  constituents,  and  the  large  abstraction 
of  this  constituent  of  the  blood  during  the  morbid  changes  in  the  integument. 

The  rapid  diminution  and  complete  disappearance  of  the  chlorides  during 
the  exudative  and  suppurative  stages  of  small-pox  is  important,  as  illus¬ 
trating  the  offices  of  these  metallic  salts  in  the  animal  economy.  The  chlor¬ 
ides  disappear  so  completely  from  the  urine  of  severe  cases  of  small-pox, 
that  nitrate  of  silver  gives  scarcely  a  perceptible  turbidness,  when  added  to 
the  urine  acidulated  with  nitric  acid.  The  wide  diffusion  of  the  chloride  of 
sodium  through  the  solid  and  fluid  portion  of  the  earth’s  surface,  and  its 
similar  diffusion  throughout  all  animal  substances  in  definite  proportions, 
as  well  as  the  craving  of  men  and  animals  for  this  substance,  and  its  estab¬ 
lished  beneficial  effects  when  used  as  an  article  of  food,  point  to  the  im¬ 
portance  of  this  substance  in  the  metamoiphosis  of  animal  tissues.  It  is  now 
well  established  that  this  salt  is  constantly  associated  with  certain  animal 
matters,  and  essentially  influences  their  chemical  and  physical  properties, 
rendering  albumen,  casein,  and  fibrin  more  soluble,  and  modifying  their 
coagulating  properties.  The  influence  which  this  salt  exercises  on  these 
protean  compounds,  and  upon  the  physical  properties  of  the  blood  cor¬ 
puscles,  as  well  as  its  relations  to  urea  and  glucose,  renders  this  view  prob¬ 
able  that  it  is  capable  of  forming  definite  chemical  compounds  with  certain 
organic  bodies  which  are  most  active  in  the  changes  characteristic  of  in¬ 
flammation. 

Recent  investigations  upon  the  composition  of  inflammatory  exudations, 
pus  and  muces,  indicate  that  this  salt  discharges  an  important  office  in 
the  metamorphosis  of  the  inflammatory  materials  of  various  diseases,  as 
pneumonia  and  small  pox. 

And  it  is  not  unreasonable  to  refer  the  absence  of  this  salt  in  the  urine 
in  small-pox,  not  merely  to  the  diminution  of  the  amount  ingested  with 
the  food,  but  to  its  abstraction  by  the  exudation,  and  the  part  which  it 
plays  in  the  metamorphosis  of  the  organic  constituents  into  organized  cells 
and  fibres. 

We  have  thus  established  by  the  preceding  observations  that — 

1.  Cow-pox  (vaccination)  produces  a  profound  change  in  the  chemical 

constitution  of  the  human  body.  & 

2.  When  the  small-pox  poison  induces  fever  after  vaccination,  and  the 
disease  appears  in  a  modified  form,  known  as  varioloid,  the  course  of  the 


Spurious  Vaccination. 


251 


temperature  differs  in  a  marked  degree  from  that  of  true  small-pox  ;  in  the 
former  the  fever  is  continuous  and  forms  but  one  paroxysm  ;  in  the  latter 
the  fever  is  intermittent  or  remittent. 

In  varioloid  the  fever  subsides  and  disappears  with  the  appearance  of 
the  eruption. 

In  small-pox,  the  fever  often  subsiding  after  the  appearance  of  the  erup¬ 
tion,  reappears  during  the  filling  of  the  vesicles  or  eruption  with  pus. 

3.  In  varioloid  the  increment  of  urea,  uric  acid,  free  acid,  phosphoric 
acid  and  sulphuric  acid  in  the  urine  is  comparatively  slight. 

4.  In  small-pox  there  is  a  marked  increment  in  the  urea,  uric  acid,  free 
acid,  phosphoric  acid  and  sulphuric  acid. 

5.  The  action  of  the  vaccine  virus  tends  to  prevent  secondary  fever  and 
rapid  oxidation  of  the  nitrogenesed  and  phosphorized  constituents  of  the 
blood,  muscles  and  nervous  tissue. 

6.  It  is  evident  that  the  cow-pox  virus  protects  from  small-pox,  by  pro¬ 
ducing  profound  changes  in  the  chemical  constitution  of  the  solids  aud 
fluids  of  the  human  body. 


SPURIOUS  VACCINATION  OR  THE  ABNORMAL  PHENOMENA 
ACCOMPANYING  AND  FOLLOWING  VACCINATION. 


CAUSES  OF  THE  VARIOUS  DEVIATIONS  OF  VACCINE  DISEASE  FROM  ITS 
NORMAL  COURSE— DANGER  OF  THE  INTRODUCTION  OF  OTHER  DISEASES 
INTO  THE  ORGANISM  BY  VACCINATION,  VACCINO-SYPH1ILTIC  INOCULA¬ 
TION— POST-VACCINAL  SYPHILIS. 

No  question  is  of  greater  importance  to  the  citizens  of  the  United  States 
of  America,  than  the  arrest,  prevention  and  exclusion  of  small-pox.  This 
loathsome  disease  has  in  past  times  after  its  introduction  by  Europeans 
depopulated  the  native  races  of  the  North  American  continent;  and  but  for 
the  practice  of  vaccination  by  the  Medical  Profession  of  the  United  States, 
smallpox  would  find  a  permanent  home  in  this  great  aud  growing  country; 
and  the  facilities  of  travel  by  steamboat  and  railroad  are  so  great  that 
scarcely  a  citizen  of  this  mighty  republic  would  escape  this  foul  pestilence. 
The  question  of  the  arrest  and  exclusion  of  small-pox  is  of  especial  interest 
to  the  citizens  of  Louisana,  who  in  virtue  of  the  geographical  position  of 
their  State,  hold  the  key  to  the  Missisippi  valley. 

We  have  established  by  original  investigation  and  by  statistics  derived 
from  official  sources,  and  consolidated  especially  for  this  inquiry,  the  great 
protection  afforded  by  vaccination  to  the  citizens  of  the  Eastern,  Middle  and 
Southern  States,  whose  settlement  and  history  antedated  by  periods  ranging 
from  seventy  to  two  hundred  and  more  years,  the  announcement  of  the 
discovery  of  Edward  Jenner. 

It  remains  that  the  value  of  vaccination  should  be  impartially  considered 
in  all  its  varied  respects,  and  that  all  sources  of  accident,  error  and  danger 
arising  from  this  operation  should  be  fairly  discussed. 


252 


Spurious  Vaccination. 


The  experience  gathered  by  the  medical  officers  of  the  Southern  (Con¬ 
federate)  Army  during  the  great  American  Civil  War  of  1861-1865  was  of 
great  value,  and  opened  an  entirely  new  chapter  in  the  history  of  vac¬ 
cination. 

At  the  present  time  the  enemies  ot  vaccination  appear  to  be  gathering 
renewed  strength,  from  the  apparent  failures  and  accidents  occasionally 
attending  this  operation. 

Like  all  other  great  discoveries,  vaccination  has  been  atone  time  extolled 
for  powers  which  it  does  not  possess,  and  at  others  blamed  for  accidents 
for  which  it  was  not  justly  chargeable. 


IN  THE  EARLY  HISTORY  OF'  VACCINATION,  PROTECTIVE 
POWERS  AGAINST  CERTAIN  DISEASES  WERE  ERRONE¬ 
OUSLY  ATTRIBUTED  TO  COW-POX  INOCULATION. 

Soon  alter  the  world  was  informed  that  the  vaccine  poison  was  preven¬ 
tative  of  the  small-pox,  a  disposition  was  shown  by  physicians  and  specu¬ 
lative  men  to  extend  its  influence  and  prophylastic  powers  toother  diseases. 

The  idea  was  advanced,  that  the  morbid  action  excited  by  the  virus  from 
the  cow,  could  as  well  prevent  other  contagious  distempers,  as  that  one  for 
which  it  was  particularly  employed ;  and  if  it  was  capable  of  doing  such 
good  in  the  human  constitution  it  would  be  no  less  operative  in  the  bodies 
of  brutes. 

Accordingly  it  was  said  that  the  plague  of  Syria,  could  be  prevented 
by  previous  vaccination  ;  but  M.  Valli  who  made  the  experiment  on  himself 
was  seized  afterwards  by  the  plague. 

This  alleged  power  of  vaccination  in  controlling  the  plague,  attracted 
at  an  early  period  a  considerable  degree  of  attention,  and  Dr,  Jenner  received 
letters  on  this  subject  from  many  quarters. 

The  circumstances  having  been  made  known  to  the  Spanish  Consul  at 
Morocco,  a  communication  was  transmitted  to  Sir  Joseph  Banks  on  that 
subject,  and  from  him  to  Jenner. 

The  opinion  of  Jenner  on  this  point  was  thus  expressed. 

“ I  never  was  so  sanguine  in  my  hopes  of  seeing  the  plague  extinguished  by  vaccine 
inoculation  as  some  of  my  friends  were,  as  you  may  have  seen  by  the  few  introductory 
lines  which  accompanied  Dr.  Carro’s  letters  in  the  public  papers.’’  “I  will  just  drop  a 
hint ;  the  vaccine  disease,  in  my  opinion,  is  not  a  preventive  of  the  small-pox,  but  the 
small-pox  itself ;  that  is  to  say, the  horrible  form  under  which  it  appears  in  its  contagious 
state  is  (as  I  conceive)  a  malignant  variety.  Now  if  it  should  ever  be  discovered  that 
the  plague  is  a  variety  of  some  milder  disease  generated  originally  in  a  way  that  may 
even  elude  our  researches,  and  the  source  should  be  discovered  from  whence  it  sprang 
this  may  be  applied  to  a  great  and  grand  purpose.  The  phenomena  of  the  cow-pox  open 
many  paths  for  speculation,  every  one  of  which  I  hope  may  be  explained.” 

The  prophetic  hope  of  Jenner,  breathed  more  than  half  a  century  ago,  has 
and  is  being  realized  in  our  day  by  the  investigations  of  Pasteur,  Koch  and 
others. 

M.  Valentine  of  Marseilles,  in  a  letter  to  Dr.  Samuel  Mitchell  of  New 
York  presented  the  following  : 

“  I  think  it  may  be  agreeable  to  you  to  become  acquainted  with  a  letter 
written  by  the  Hospodar  of  Wallachia,  to  my  friend,  Dr.  Carro,  of  Vienna. 
It  was  published  a  few  months  ago,  in  the  Bibliotheque  Britanique ,  a  French 
journal  published  at  Geneva.  That  Prince  is  well  known  to  be  one  of  the 
most  learned,  polite  and  liberal  men  of  the  present  day.  What  he  says  on 
the  plague  seems  to  be  worth  a  volume. 

‘ 1  Sir — Ihave  received  the  letter  you  have  done  me  the  honor  to  write  me,  dated  April  the 
seventh,  together  with  the  work  which  accompanied  it.  I  have  perused  the  whole,  with 
the  lively  interest  which  talents  and  intrepidity  engaged  in  the  cause  of  humanity,  never 


Spurious  Vaccination. 


253 


fail  to  inspire.  After  having-  given  so  striking  an  instance  of  your  confidence  in  the 
cow-pox,  it  was  well  worthy  of  the  extent  of  your  ideas,  to  seek  a  preventive  against 
one  of  the  greatest  scourges  of  the  earth.  Bui  you  know,  Sir,  that  I  belong  to  a  country 
where  it  is  but  too  easy  to  make  observations  on  the  plague.  I  have  seen  this  capricious 
disease  assume  all  forms,  and  exhibit  the  most  opposite  symptoms.  It  has  frequently 
appeared  under  the  guise  of  an  inflammatory  fever,  and  then  suddenly  disclosing  all  the 
peculiar  symptoms,  so  that  most  inexperienced  physicians  have  been  strongly  deceived 
in  prescribing  blood-letting,  which  has  produced  the  most  fatal  effects.  Sometimes  it 
commences  its  career  by  an  inflammation  of  the  stomach ,  accompanied  by  signs  of  a  septic 
ferment,  which  infects  the  whole  alimentary  canal,  attacks  the  nervous  system,  and 
assumes  the  character  of  a  deadly  malignity.  Other  persons  seized  by  the  disease,  have 
had  no  other  symptoms  than  those  of  uneasiness  and  surprising  weakness  in  all  the  joints, 
so  that  the  physicians  could  consider  it  only  as  a  slow  fever,  invading  the  whole  nervous  sys¬ 
tem.  From  this  proteiform  variety  of  symptoms,  we  are  to  suppose  that  the  pestilential 
miasmata,  introduced  into  the  mass  of  humours  incorporated  with  them,  and  excite 
symptoms  corresponding  to  the  peculiarity  of  constitutions  in  the  sick  ;  and  that  we  are 
to  respect  a  remedy  which  promises  uniformity  either  to  prevent  this  distemper,  or  to 
cure  it. 

“  Mr.  Yalli,  on  his  passage  through  Bucharest,  owned  to  me  that  his  experiments  with 
cow-pox  had  taught  him  nothing.  [Dr.  Yalli  returned  from  Constantinople  to  Italy. 
This  is  the  man  who  inoculated  himself  for  the  plague,  and  who  shut  himself  up  in  a 
pestiferous  hospital  at  Constantinople.  All  the  hopes  he  once  entertained  of  preventing 
the  plague  by  vaccination  are  vanished.]  And  the  notion  of  guarding  against  the  plague 
by  inoculating  with  its  own  poison  promises  still  less  success,  because  it  is  very  common 
to  see  people  who  have  been  cured  of  it  ten  times  die  on  the  eleventh. 

“  Shall  I  give  you,  sir,  an  instance  of  the  whimsicalness  of  this  disease?  The  Imans 
practice  charity  with  the  most  religious  zeal.  We  observe  some  of  them  who,  after  ha  v¬ 
ing  washed,  rubbed  and  buried  thousands  ot  those  whom  the  plague  has  killed,  without 
experiencing  the  smallest  inconvenience,  are  attacked  and  overwhelmed  at  times  wheu 
they  are  least  exposed  to  the  supposed  exciting  cause.  My  opinion,  therefore,  is  that  in 
the  present  state  of  our  knowledge,  the  best  thing  we  can  do  iu  this  respect  is  to  estab¬ 
lish  hospitals,  over  which  men  of  your  merit  cannot  be  too  vigilant  for  the  purpose  of 
recommending  proper  discipline  to  governments.* 

“  I  have  the  honor  to  be,  etc.,  CONSTANTIN  YPSILANDY.” 

Dr.  Jenner  proposed  vaccination  in  hydrophobia.  Thus  in  a  letter  to 
Rev.  Dr.  Worthington,  dated  London,  Flading’s  Hotel,  Oxford  street,  June 
26,  1811,  he  says : 

“Yesterday  I  dined  with  Professor  Davy.  I  wish  you  had  beeu  with  us.  His  mind  is 
all  in  a  blaze.  He  seems  to  be  one  of  those  rare  productions  which  nature  allows  us  to 
see  in  a  score  of  centuries.  We  touched  on  hydrophobia.  He  started  an  ingenius  idea, 
that  of  counteracting  the  effect  of  one  morbid  poison  with  another.  What  think  you  of 
a  viper  ? 

“Notits  broth,  but  its  fang,  as  soon  as  the  first  symptom  of  disease  appears  from 
Canination.  If  this  should  succeed  we  must  domiciliate  vipers  as  we  have  leeches.  But 
from  this  hint  I  should  be  disposed  to  try,  under  such  an  event,  vaccination  ;  as  it  can 
almost  always  be  made  to  act  quickly  on  the  system,  whether  a  person  has  previously 
felt  its  influence  or  not,  or  that  of  the  small-pox.” 

John  Archer,  M.  D.,  of  Hartford  county,  Maryland,  recommended  vacci¬ 
nation  as  a  remedy  for  pertussis,  in  a  letter  addressed  to  Dr.  Samuel 
Latham  Mitchell,  of  Flew  York,  dated  November  15,  1808. 

Dr.  Archer  stated  that  he  had  “vaccinated  six  or  eight  patients  that 
had  the  whooping-cough,  and  in  every  case  it  succeeded  in  curing  this  most 
troublesome  disease.” 

“  The  whooping-cough  does  not  come  to  its  height  in  less  than  six  weeks  from  its  com¬ 
mencement,  and  then,  when  a  favorable  termination  is  expected,  the  declension  of  the 
disease  is  gradual  and  it  does  not  terminate  in  less  than  six  weeks  more.  To  arrest  this 
afflicting  disorder  in  its  progress,  I  would  recommend  vaccination  in  the  second  or  third 
week  of  the  whooping-cough.  The  termination  of  the  vaccine  disease  will  be  the  termi¬ 
nation  of  the  whooping-cough  ;  that  is,  as  soon  as  the  vaccinated  part  loses  the  efflores¬ 
cence,  and  the  scab  begins  to  dry  and  becomes  of  a  blueish  or  brownish  color,  there  will 
then  be  an  evident  change  in  the  whooping-cough  for  the  better,  and  the  severe  symp¬ 
toms  will  cease. — Medical  Repository.  Vol.  4,  New  Yorlc,  1809;  p.  182. 

*  The  Medical  Repository  and  Review  of  American  Publications  on  Medicine,  Surgery  and  the  Auxiliary 
Branches  of  Science.  Conducted  by  Samuel  Latham  Mitchell,  M.  D.,  and  Edward  Miller,  M,  D .  \  ol.  3. 

Xew  York,  1806;  pp.  427-429. 


254 


Spurious  Vaccination. 


“  It  was  even  reported  that  vaccination  was  an  effectual  bar  against  the  syphilis. 
With  reference  to  this  supposed  power  of  the  vaccine  virus,  a  writer  in  the  Medical  Re¬ 
pository.  in  the  year  1805  (vol.  2,  p.  70),  remarks:  ‘Of  this  power  we  nave  heard  no 
proof,  and  as  far  as  our  observations  extend,  the  old  enemy  of  the  gentlemen  of  gallantry, 
harasses  them  as  sorely  as  ever.  Should  they  be  able  to  take  shelter  behind  the  vaccine, 
it  would  be  a  protection  to  which  they  might  gladly  betake  themselves.’  ” 

It  was  also  claimed  in  the  early  part  of  tlie  nineteenth  century,*  even 
before  1805,  that  the  rot  in  sheep  could  likewise  be  prevented  by  vaccina¬ 
tion.  Experiments,  however,  demonstrated  that  the  cow-pox  was  power¬ 
less  to  preserve  these  animals  from  that  distemper.  Dr.  De  Carro  testified 
that  this  operation,  which  was  called  clavclization,  was  quite  fashionable  in 
some  parts  of  Germany,  but  that  there  were  no  facts  to  prove  that  the  ex¬ 
periments  had  prevented  rot  in  sheep.  The  expectations  entertained  of 
vaccination  preventing’  hydrophobia  in  dogs  were  equally  fallacious.* 


SPURIOUS  VACCINATION,  OR  THE  ABNORMAL  PHENOMENA 
ACCOMPANYING  AND  FOLLOWING  VACCINATION,  EX¬ 
CITED  THE  ATTENTION  OF  THE  MEDICAL  PROFESSION 
OF  ENGLAND  IN  THE  EARLIEST  PERIOD  OF  THE  HISTORY 
OF  VACCINATION. 

It  has  been  shown  by  the  preceding  works  of  Edward  Jenner,  Pearson 
and  Woodville  that  the  phenomena  of  cow-pox  and  vaccination  were  crit¬ 
ically  studied,  and  the  causes  of  deviation  in  the  progress  and  effects  of 
the  disease  carefully  noted. 

The  enemies  of  vaccination  seized  with  avidity  upon  all  facts  which 
tended  to  weaken  the  confidence  of  the  profession  and  public,  and  to  excite 
prejudice  against  the  measure  proposed  by  Dr.  Jenner  for  the  eradication 
of  small-pox. 

Drs.  Wm.  Rowley,  B.  Moseley  and  R.  Squirrel  (John  Gale  Jones)  not 
only  published  works  against  vaccination,  but  circulated  prints  represent¬ 
ing  the  human  visage  in  the  act  of  transformation  and  assuming  that  of  a 
cow.  Dr.  William  Rowley  exhibited  in  all  the  touching  simplicity  of 
graphic  delineation  a  Master  Jowles,  the  cow-poxed ,  ox-cheeked  young  gentle¬ 
man,  and  the  Miss  Mary  Ann  Lewis  the  cow-poxed  and  cow-manged  young 
lady. 

The  articles  of  this  celebrated  triumvonate — Moseley,  Rowley  and  Squir¬ 
rel — appeared  in  the  columns  of  the  Independent  Whig  and  of  the  Medical 
Observer ,  and  also  as  separate  treaties. 

I  have  in  my  possession  a  translation  in  French  of  the  books  of  Rowley, 
Moseley  and  Squirrel,  entitled  as  follows : 

La  vaccine  combattue  dans  le  Fays  ou  elle  apris  naissance ,  on  traduction  de 
Trois  ouvrages  Anglais  ;  Savori. 

t.  De  Vinefficacite  et  des  dangers  de  la  vaccine  ;  ouvrage ,  dans  lequel  sont , 
rapportes  plus  de  cinq  cents  accidents  ;  suivi  d’un  Mode  de  Trait ement pour  les 
Maladies  cause es par  la  vaccine,  Tr admit  sur  la  troisieme  edition  de  docteur  Wil¬ 
iam  Roivley,  auteur  de  la  Medecine  Universelle,  Mernbre  de  V  TJniversitive  d'  Ox¬ 
ford,  du  College  Royal  de  Medicine ,  et  professeur,  etc. 

2.  Discussion  Historique  et  critique  sur  la  vaccine,  par  Ie  Docteur 
Moseley,  M6dicin  de  l’Hospital  Militaire  de  Chelsea,  mernbre  de  College 
de  Medecine  de  Londres,  auteur  d’  un  traite  sur  les  Maladies  tropiques  des 
Rapports  faits  au  comite  de  laChambredes  Communes,  par  plusieurs  Mede- 
cius  et  Chirurgiens,  concernant  la  vaccine. 


*The  Medical  Repository,  vol.  2 ;  New  York,  1805 ;  pp.  75-76. 


Spurious  Vaccination. 


255 


3.  Observations  sur  l’liioculation  variolique  tenclant,  prouver  qn’elle 
est  plus  salut-aire  pour  le  genre  liumain  quela  vaccination  ;  par  R.  Squirrel, 
docteur  en  Medecin,  aucien  pharmacien  a  l’Hospital  de  la  petite  verole  et 
d’inoculation.  .  v 

Aux  Deux  Gravures  Oolorices.  A  Paris,  Chez  Gignet  et  Michaud,  Im- 
prim. ;  Libraires,  Rue  des  Bous-Enfants,  No.  34,  1807. 

The  work  of  Dr.  William  Rowley  is  illustrated  by  504  examples  or  cases 
of  “the  accidents  occasioned  by  vaccination.” 

Dr.  Moseley,  physician  to  Chelsea  Hospital,  first  made  his  attack  upon 
the  cow-pox  m  a  treatise  on  sugar ;  and  his  bitterness  and  prejudice  claimed 
to  see  in  distant  prospects,  an  awful  aggravation  of  human  ills,  from  an 
admixture  of  bestial  humours,  which  the  cow  mania  as  he  elegantly  termed 
it  threatened  to  intiict  upon  the  human  race.  He  even  predicted  an  altera¬ 
tion  in  “  the  human  form  divine,”  and  that  another  brood  of  minotuars  would 
overspread  the  land  “  Semibovemque  virum  Semiviriemque  borum.” 

This  attack  of  Dr.  Moseley  on  vaccination  brought  out  many  champions, 
on  the  side  of  Dr.  Jenner,  prominent  amongst  whom  was  Mr.  John  Ring. 

At  first  Mr.  Ring’s  opinion  011  vaccination  had  been  somewhat  modified 
by  the  publications  of  Drs.  Pearson  and  Woodville;  but  when  Dr.  Jenner’s 
accurate  details  were  confirmed  and  illustrated  by  his  own  experience,  he 
devoted  a  great  part  of  his  professional  life  to  the  cause  of  vaccination.  Mr. 
Ring  investigated  every  adverse  case  that  he  heard  of  in  London  ;  he  offered 
gratuitous  vaccination  to  all  who  would  accept  of  it ;  and  he  marshalled  the 
chief  medical  men  in  London,  who  had  satisfied  themselves  of  its  efficacy, 
by  procuring  their  signatures  to  the  following  testimony. 

“Many  unfounded  reports  have  been  circulated,  which  have  a  tendency  to  prejudice 
the  public  against  inoculation  for  the  cow-pox.  We,  the  undersigned,  physicians  and 
surgeons,  think  it  our  duty  to  declare  an  opinion  that  those  persons  who  have  had  the 
cow-pox  are  perfectly  secure  from  the  future  infection  of  the  small-pox.  We  also  de- 
clare  that  the  inoculated  cow-pjx  is  a  much  milder  and  safer  disease  than  the  inoculated 
small-pox.” 

This  document  bears  the  signature  of  thirty-three  of  the  most  eminent 
physicians,  and  of  forty  distinguished  surgeons  of  the  London  College  of 
Surgery,  amongst  whom  are  the  well-known  names  of  Bailie  Vaughn 
(afterwards  Sir  Henry  Halford),  Cline,  Cooper,  Abernethy,  Lettsom,Wilian, 
Garthshere,  Matou,  Lynn,  Blair,  Dundas,  Good,  John  Pearson,  James 
Moore,  Saunders,  Croft,  Garnett,  etc.,  etc.  • 

Dr.  Jenner,  in  a  letter  to  R.  Dunning.  Esq.,  dated  Berkley,  February  10, 
1805,  thus  alludes  to  the  subsequent  publication  of  Dr.  Moseley: 

“  Have  you  seen  Moseley’s  infamous  pamphlet  ?  You  ask  for  fatal  cases  of  the  vaccine. 
This  gentlemen,  in  one  single  paragraph,  furnishes  you  with  some  of  the  most  terrible 
deaths  that  were  ever  heard  of  from  this  cause,  Oue  would  suppose  he  was  speaking  of 
the  small-pox,  as  he  tells  us  the  children  did  not  lose  their  torments  even  in  the  article 
of  death!  Luckily,  he  takes  away  every  thing  like  truth  that  can  attach  to  this  history 
by  omitting  every  kind  of  reference.  What  punishment  does  a  man  of  this  description 
merit  ?  ” 

In  a  letter  addressed  to  R.  Dunning,  Esq.,  dated  Cheltenham,  February  21,  1806,  lie  thus 
characterizes  the  injurious  effects  of  the  statements  of  Rowley,  Moseley  and  Squirrel  : 

“What  havoc  the  anti- vaccinationists  have  made  in  town  by  the  rein  trod  action  ot  v  - 
riolous  inoculation!  It  is  computed  that  since  April  last,  not  less  than  6,000  persons  in 
the  metropolis,  and  the  villages  immediately  in  contact,  have  fallen  victims  to  the  small  - 
pox.  One  would  scarcely  conceive  it  possible  ;  but  these  murders  are,  for  the  most  part, 
to  be  attributed  to  the  absurd  productions  of  Moseley,  Rowley,  and  that  pert  little 
Squirrel,  to  say  nothing  of  Goldsou. 

It  is  about  London  that  the  venom  of  these  deadly  serpents  chieliy  Hows.  So  little 
have  the  people  around  me  (though  only  100  miles  from  it)  felt  it,  that  since  August  last 
I  have  vaccinated  within  a  few  of  1500;  and  1  must  certainly  deem  it  a  piece  of  extreme 
good  fortune  that  out  of  the  many  thousands  I  have  vaccinated,  no  failure  or  accident 


256 


Spurious  Vaccination. 


of  any  sort  has  arisen  to  my  knowledge.”  “Did  you  see  a  paper  in  the  last  Journal  from 
a  Dr.  Wood  ?  I  think  it  capable  of  doing  great  mischief,  as  it  will  tend  to  make  practi¬ 
tioners  careless  about  a  point  of  great  consequence,  namely,  an  herpetic  state  of  the 
skin,  coincident  with  vaccination,  which  you  as  well  as  myself,  have  not  only  observed, 
but  publicly  and  very  properly  noticed.  My  communications  from  various  parts  of  the 
world  are  very  cheering — 800,000  cases  from  India.” 

Dr.  Jenner,  in  connection  with  the  subject  of  the  interference  of  herpes 
with  the  vaccine  pustules,  again  refers  to  Dr.  Moseley,  in  a  letter  to  it. 
Dunning,  Esq.,  dated  Berkley,  April  22,  1806  : 

“  The  impertinent  interference  of  herpes  with  our  vaccine  pustules,  I  thought  of  so 
much  consequence  to  he  generally  known,  as  to  induce  me  to  reprint  my  paper  on  the 
subject  for  distribution.  With  this  you  will  receive  two  copies  ;  one  of  which  I  must 
beg  your  acceptance  of;  and  the  other  you  will  have  the  kindness  to  present  to  the  Dock 
Jennerian  Society,  with  my  grateful  respects  to  the  members.  You  will  do  much  public 
good  by  enforcing  attention  to  the  progress  of  the  vaccine  pustule.  If  it  he  torn  to 
pieces,  either  by  the  nails  or  the  lancet,  before  the  business  for  which  it  was  placed  upon 
the  arm  was  accomplished,  it  is  unreasonable  to  suppose  that  perfect  security  can  follow. 
But  to  what  purpose  shall  you  or  I  address  the  public  on  these  subjects,  while  such  un¬ 
principled  characters  as  Moseley,  and  those  who  enlist  under  his  banner,  still  continue 
to  instil,  or  rather  to  push  by  violence,  into  the  minds  of  the  British  nation  their  doc¬ 
trines?  Have  you  seen  Moseley’s  last  pamphlet,  the  one  just  published?  It  is  far  more 
violent  than  any  of  the  preceding.  In  this  he  has  brought  forward  a  string  of  cases  to 
point  out  my  failures  in  vaccination — cases  of  small-pox  after  cow-pox.  But  mark  his 
audacity.  They  are  of  children  I  never  saw  in  my  life,  and  whose  names  I  never  heard  of 
till  they  were  placed  before  me  in  the  murderons  publication.  Mr.  H.  Jenner,  whose 
name  he  brings  forward  with  a  list  of  failures  annexed,  assures  me  that  the  whole  is  a 
most  impudent  forgery.  What  can  be  done  with  such  a  man  as  this  ?  A  general  mani¬ 
festo  with  the  signatures  of  men  of  eminence  in  the  profession  (and  I  really  think  we 
should  now  embrace  nearly,  if  not  quite,  the  wholej,  in  favor  of  vaccination,  would,  if 
anything  could,  crush  the  hissing  heads  of  such  serpents  at  once  ;  and  I  fear  nothing 
short  of  it,  unless  Parliament  had  a  mind  again  to  take  the  matter  up.” 

From  the  preceding  extracts  it  is  evident  that  Dr.  Jenner  has  made  a 
careful  study  of  the  effect  of  skin  diseases  upon  the  progress  of  the  vac¬ 
cine  vesicles ;  and  we  find  him  thus  alluding  to  the  same  subject  in  a  letter 
dated  Berkley,  February  the  tenth,  1805. 

“  Iu  the  cicatrix  of  those  children  on  whose  arms,  through  the  intervention  of  herpes* 
the  pustule  has  proceeded  irregularly,  I  lind  in  general  a  singular  deviation,  which  it 
will  be  difficult  to  describe  by  words  and  I  draw  most  wretchedly.  Instead  of  the  flat, 
correct  indentation,  the  cicatrix  exhibits  a  preceptible  elevation  of  a  conical  shape, 
though  very  slightly  so.  I  have  a  fine  specimen  in  a  child  lately  inoculated,  with  recent 
tinea  capiles,  and  shall  endeavor  to  take  a  cast  in  wax  or  Paris  plaster.  Indeed  a  series 
of  pustules  might  be  done  in  this  way,  and  afterwards  colored.” 

The  important  suggestion  of  Dr.  Jenner,  with  reference  to  casts,  andillus- 
trations  of  the  vacciue  cicatrix  was  fulfilled  in  an  able  manner  by  J.  E.  B- 
Denarp  Decanteleu  in  his  Monographic  des  cicatrices  de  la  vaccine,  pub¬ 
lished  at  Paris  in  1851. 

Dr.  Denarp  Decanteleu  published  a  large  lithographic  drawing,  copied 
from  a  collection  of  casts  in  stucco,  taken  from  the  arms  of  a  large  number 
of  subjects,  this  collection  of  casts  of  vaccine  scars,  colored  after  nature, 
the  author  refers  to  in  the  single  number  of  his  unfinished  Monograph, 
and  offered  them  for  the  inspection  of  his  readers  as  corroborativeof  the 
accuracy  of  his  drawing*. 

Dr.  Jenner  held  that  the  herpetic  affections  affected  the  progress  of 
variolous  inoculation,  as  well  as  that  of  the  cow-pox.  His  views  are  thus 
stated  in  a  letter  to  James  Moore,  Esq.,  dated  Berkley,  February  26, 1810: 

“Do  you  not  intend  mentioning  cases  of  small-pox  after  supposed  security  from  small¬ 
pox  inoculation  ?  Such  cases  are  innumerable.  I  think  there  are  thirteen  on  record 
among  the  families  of  the  nobility.  Blair,  1  believe,  has  collected  the  greatest  number  ' 


*Dr.  Henry  Austin  Martin  of  Boston  purchased,  from  the  publisher,  Balliere  of  Paris,  all  that  remained 
of  the  edition  ot  this  work  ;  and  1  am  indebted  to  the  courtesy  and  generosity  of  Dr.  Martin  for  a  copy  of 
this  valuable  contribution  to  the  history  of  vaccination. 


Spurious  Vaccination. 


257 


of  them.  You  know  my  old  opinion  of  the  matter  ;  that  they  occur,  for  the  most  part, 
through  the  interference  of  herpetic  affections  at  the  time  of  inoculation.  One  decisive 
proof  you  will  find  in  Willan’s  Vaccine  Book,  given  hy  me.  From  facts  I  go  to  hypo¬ 
thesis;  and  conceive  that  the  appearance  of  the  small-pox  twice  in  the  same  individual 
arises  from  the  same  cause  ? 

“On  this  subject  I  could  write  along  chapter;  hut  as  it  would  necessarily  he  theoretical, 
you  would  not  thank  me  for  it.  I  must  just  touch  upon  it.  We  see  that  variolous  matter 
may  degenerated  by  inoculation  on  the  arms  of  one  person  in  that  degree  of  perfection 
as  to  communicate  the  small-pox  by  transferring  it  to  those  of  another;  yet  the  person 
whose  constitution  shall  in  the  first  instance  have  been  exposed  to  it,  shall  remain  unpro¬ 
tected  from  future  infection,  although  the  system  has  been  deranged  during  its  presence 
on  the  skin.  Where,  then,  is  the  difference,  whether  the  morbid  poison  was  confined  or 
limited  to  a  point  or  two,  or  spread  universally  in  the  form  of  pustules.  If  the  change 
required  to  give  security  could  not  take  place  in  this  one  instance,  why  should  it  in  an¬ 
other  under  the  same  existing  circumstances?  The  peculiarity  of  the  action  (I  do  not  like 
to  call  it  morbid,  because  it  is  generally  salutary),  is  often  too  strong  to  be  overcome, 
yet  I  am  ready  to  conclude  that  this  is  not  a  frequent  occurrence. 

“  The  more  I  reason  upon  it,  the  more  I  am  convinced  that  the  idea  I  broached  in  my 
first  publication  on  the  cow-pox,  namely  :  that  poisonous  animal  fluids  are  not  absorbed 
and  carried  into  the  blood  vessels  is  correct.” 

In  the  same  letter  to  Mr.  Moore,  Dr.  Jenner  thus  exposes  and  disposes  of 
his  enemy,  the  notorious  “ Squirrel :  ” 

“John  Gale  Jones,  I  see,  has  at1  length  succeeded  in  obtaining  the  situation  for  which 
he  has  long  been  a  candidate.  This  fellow  had  once  the  impudence  to  desire  a  man  to 
call  on  me  in  Bedford  Place,  to  say,  that  he,  Jones,  would  advise  me  immediately  to 
quit  London,  for  there  was  no  knowing  what  an  outraged  populace  might  do.  He  was 
the  writer  of  Squirrel’s  book,  the  long  anti-vaccine  columns  in  the  Independent  Whig,  and 
many  of  the  most  violent  papers  in  the  Medical  Observer.  I  was  held  up  in  his  Forum 
for  several  nights  as  an  object  of  derison  ;  but  I  silenced  him  by  the  same  weapon  as  I 
had  many  others — contempt.” 


' 


s 


■ 

' 

1 1  • 


■ 


■  •-* ' '  i  * * 

- 


' 

. 


RESEARCHES  UPON  “SPURIOUS  VACCINATION,”  OR  THE  AB- 
NORMAL  PHENOMENA  ACCOMPANYING  AND  FOLLOWING 
VACCINATION  IN  THE  CONFEDERATE  ARMY,  DURING  THE 
RECENT  AMERICAN  CIVIL  WAR,  1861-1865. 


SECTION  1. -PRELIMINARY  OBSERVATIONS— ACCIDENTS  ATTENDING  VACCI¬ 
NATION  AMONGST  THE  *  ITIZENS  AND  SOLDIERS  OF  THE  CONFEDERATE 
STATES— NECESSITY  FOR  THE  INVESTIGATION— METHOD,  EXTENT  AND 
OBJECT  OF  THE  INQUIRY— THE  INJURIOUS  EFFECTS  OF  VACCINATION 
REFERRED  TO  SIX  CAUSES— CIRCULAR  LETTER  ADDRESSED  TO  THE 
MEDICAL  OFFICERS  OF  THE  LATE  CONFEDERATE  ARMY— FACTS  ILLUS¬ 
TRATING  THE  VALUE  OF  VACCINATION  AND  THE  FATALITY  OF  SMALL¬ 
POX-DESCRIPTION  OF  SMALL-POX  BY  SIR  MATTHEW  HALE— DR.  JEN- 
NER  POINTED  OUT  SOME  CAUSES  OF  THE  ACCIDENTS  ATTENDING  VAC¬ 
CINATION  AND  GAVE  RULES  FOR  THEIR  AVOIDANCE. 

During  the  recent  civil  war,  untoward  results  followed  vaccination,  and 
a  number  of  deaths  both  amongst  the  troops  and  citizens  were  directly  re¬ 
ferable  to  the  effects  of  vaccination.  So  great  was  the  evil  in  the  army, 
that  it  was  made  a  special  subject  of  investigation,  and  a  number  of  inter¬ 
esting  reports  were  prepared  by  several  of  the  medical  officers,  upon  what 
was  most  generally  called  in  the  army,  “  spurious  vaccination.”  Our 
friend,  Surgeon  Jackson  Chambliss,  in  charge  of  Div.  No.  1,  Camp  Winder 
Hospital,  Biehmond,  had  examined  and  recorded  a  large  number  of  cases 
of  “  spurious  vaccination,”  illustrated  with  drawings  of  the  various  local 
diseases  and  skin  affections.  As  far  as  our  information  extends, this  valu¬ 
able  mass  of  matter,  relating  to  one  of  the  most  important  subjects  in  its 
bearings  upon  the  welfare  of  the  human  race,  was  destroyed  during  the 
evacuation  of  Biehmond. 

So  common  had  accidents  become  after  vaccination,  and  so  strong  was 
the  prejudice  growing,  both  in  the  army  and  amongst  citizens  against  its 
employment,  that  we  instituted  a  series  of  experiments  upon,  the  inocula¬ 
tion  of  cows  with  small  pox  matter,  in  order  to  produce,  if  possible,  cow- 
pox,  from  whence  a  supply  of  fresh  and  reliable  vaccine  matter  might  be 
obtained.  It  was  our  design  to  carry  out  au  extensive  series  of  investiga¬ 
tions  upon  the  various  secondary  affections  following  vaccination,  and  to 
determine,  if  possible,  what  contagious  principles  could  be  associated  with 
the  lymph  of  the  vaccine  vesicle.  These  labors  were  brought  to  a  sudden 
and  unexpected  close,  by  the  disastrous  termination  of  the  civil  war.  As 
far,  however,  as  our  labors  amongst  the  Confederate  troops  extended,  we 
were  led  xo  attribute  the  injurious  effects  of  vaccination  to  the  following 
causes :  , 

1st. — Depressed  forces,  consequent  upon  fatigue  and  exposure  and  poor  diet ; 
impoverished ,  vitiated  and  scorbutic  condition  of  the  blood  of  the  patients  vac¬ 
cinated ,  or  yielding  vaccine  matter. 


260 


Spurious  Vaccination:  Joseph  Jones,  M.  I). 


2d. — The  employment  of  matter  from  pustules  or  ulcers  which  had  deviated 
from  the  regular  and,  usual  course  of  development  of  the  vaccine  vesicle;  such 
deviation  or  imperfection  in  the  vaccine  disease  or  pustule  being  due  mainly  to 
previous  vaccina  tion ,  and  the  existence  of  some  eruptive  disease  at  the  time  of 
vaccination.  Or,  in  other  words,  the  employment  of  matter  from  patients  who 
had  been  previously  vaccinated ,  and  who  were  effected  with  some  shin  disease  at 
the  time  of  the  insertion  of  the  vaccine  virus. 

3d. — Dried  Vaccine,  Lymph  or  Scabs,  in  which  decomposition  has  been  ex¬ 
cited  by  carrying  the  matter  about  the  person  for  a  length  of  time,  and  thus  sub¬ 
jecting  it  to  a  warm,  moist  atmosphere. 

4th — The  mingling  of  the  Vaccine  Virus  with  that  of  the  Small-Pox — matter 
taken  from  those  who  were  vaccinated  while  they  were  laboring  under  the  action 
of  the  poison  of  Small-Pox,  teas  capable  of  producing  a  modified  Variola,  and 
comparatively  mild  disease  in  the  inoculated ,  and  teas  capable  of  communicating 
by  effluvia  Small-Pox  in  its  worst  character  to  the  unprotected. 

5th. — Dried  Vaccine,  Lymyh  or  Scabs,  from  patients  who  have  suffered  with 
Erysipelas  during  the  progress  of  the  Vaccine  Disease ,  or  whose  systems  were  in 
a  depressed  state  from  improper  diet,  bad  ventilation,  arid  the  exhalations  from 
Typhoid  Fever ,  Erysipelas,  Hospital  Gangrene.  Pyaemia,  and  offensive  suppur¬ 
ating  wounds. 

6th — Fresh  and  dried  Vaccine  Lymph  and  Scabs,  from  patients  suffering 
from  Syphilis,  at  the  time,  and  during  the  progress  of  vaccination  and  the  vac¬ 
cine  disease. 

I  addressed  a  large  number  of  communications  relating  to  u  Spurious  vac¬ 
cination,1'1  to  Southern  physicians  formerly  connected  with  the  Confederate 
Army,  and  the  replies  to  these  inquiries  will  be  found  in  the  following  pages. 

The  following  is  the  general  form  of  circular  employed  : 


- - - 18— 

- ,  M.  D. 

Dear  Sir — 

*  *  *  *  *  ******* 

In  the  circumscribed  and  distressed  condition  of  the  Southern  States,  cut  off  from  the 
surrounding  world,  with  the  necessity  of  Vaccinating  the  entire  male  population  capable 
of  beariug  arms,  and  without  any  means  of  obtaining  fresh  and  reliable  matter  outside 
of  the  Confederate  States,  the  experience  of  the  Medical  Officers  of  the  Confederate 
Army  possesses  a  high  and  peculiar  value. 

I  shall  be  glad  to  receive  from  you  a  communication,  setting  forth  your  views  at  length 
upon  the  nature  and  value  of  Modified  Inoculation,  and  upon  the  Nature  and  Causes  of 
the  Accidents  resulting  from  Vaccination  (‘'Spurious  Vaccination  ”)  in  the  Confederate 
Army. 

The  subject  of  the  transmission  of  Syphilis  through  the  medium  of  the  Vaccine  Virus, 
should  be  carefully  discussed,  and  all  conclusions  should  be  supported  by  carefully  re¬ 
corded  facts  and  cases.  One  well  reported  case,  proving  the  transmission  of  Constitutional 
Syphilis,  or  any  other  disease,  as  Erysipelas,  by  vaccination,  is  worth  large  volumes  of 
mere  opinions  and  assertions. 

We  should  exercise  the  utmost  caution  in  discussing  the  value  of  vaccination,  and  the 
causes  of  the  accidents,  which  have  tended  of  late,  to  bring  it  into  disrepute  with  the 
public;  for  all  conscientious  physicians  and  lovers  of  mankind  will  agree  that  this 
question  is  interesting,  not  only  to  the  physiologist  and  medical  practitioner,  but  that  it 
concerns  every  community  on  the  earth,  and  comes  home  to  every  individual  of  the  hu¬ 
man  race. 

It  has  been  well  said,  by  a  writer  who  was  not  a  medical  man,  “It  is  difficult  to  con¬ 
ceive  that  there  should  be  one  being  who  would  not  be  affected  by  its  decision,  either  in 
his  own  person,  or  by  those  of  his  nearest  connexions.  To  the  bulk  of  mankind  wars 
and  revolutions  are  things  of  infinitely  less  importance ;  and  even  to  those  who  busy 
themselves  in  the  tumult  of  public  affairs,  it  may  be  doubted  whether  anything  can  oc¬ 
cur  that  will  command  so  powerful  and  permanent  an  interest,  since  there  are  few  to 
whom  fame  or  freedom  can  he  so  intimately  and  constantly  precious  as  personal  safety 
and  domestic  affection.” 


Spurious  Vaccination:  Joseph  Jones ,  M.  D. 


261 


It  is  important  that  we  should  carefully  distinguish  the  accidents  which  result  from 
the  carelessness  iu  the  selection  of  the  matter,  and  from  ignorance  of  the  true  character 
and  progress  of  the  vaccine  disease. 

You  will  oblige  me  by  answering  at  an  early  day,  and  also  by  forwarding  the  address 
of  any  physicians  who  have  made  this  subject  a  special  study,  and  who  have  recorded 
trustworthy  observations.  Very  respectfully  yours,  JOSEPH  JONES. 

This  circular  letter  was  not  as  widely  distributed  as  desired;  as  it  has 
been  difficult  to  ascertain  the  address  of  many  of  the  medical  officers  of  the 
Southern  Army,  on  account  of  the  sudden  manner  in  which  the  struggle 
terminated,  and  the  utter  and  sudden  loss  of  all  organization  and  records, 
and  on  account  of  the  imperfect  mail  facilities  of  the  Southern  States. 

The  replies  which  have  been  received  in  response  to  my  letters,  will  be 
found  under  the  different  divisions  of  the  inquiry ;  and  we  have  preferred 
presenting  each  paper  entire,  when  using  it  for  the  illustration  of  some 
particular  branch  of  the  subject,  although  it  might  contain  some  matter 
irrelevant  to  the  subject  under  immediate  consideration.  In  this  mauner 
we  hoped  to  do  justice  to  those  contributing  facts  and  observations;  and 
whilst  we  have  freely  expressed  the  results  of  our  investigation,  and  given 
our  judgment  without  reserve,  we  have  endeavored,  on  the  other  hand,  to 
avoid  all  personal  criticism. 

Before  proceeding  to  the  discussion  of  the  subjects  under  consideration, 
it  is  but  just  that  I  should  disclaim  all  designs  of  decrying  vaccination 
when  properly  performed.  Nothing  is  farther  from  my  intention,  than 
even  in  the  remotest  manner,  to  detract  from  the  value  of  the  greatest  phys¬ 
ical  boon  ever  bestowed  by  a  mortal  upon  the  human  race. 

From  authentic  documents  and  accurate  calculations,  it  has  been  ascer¬ 
tained  that  owe  in  fourteen,  of  all  that  were  born,  died  of  the  small-pox, 
even  after  inoculation  had  been  introduced  ;  and  of  persons  of  all  ages 
taken  ill  of  the  small-pox  in  the  natural  way,  one  in  five  or  six  died  ;  and 
in  addition  to  this  frightful  mortality,  alike  observable  in  all  the  different 
regions  of  the  globe,  many  of  those  who  recovered  were  permanently  dis¬ 
figured,  or  deprived  of  eyesight,  or  left  with  shattered  constitutions  the 
prey  to  pulmonary  consumption,  chronic  opthalmia,  and  scrofula. 

According  to  the  researches  of  Black,  Liissmileh  and  Frank,  eight  or 
nine  per  cent,  of  the  human  race  were  carried  off  by  small-pox  :  and  Duvil- 
lard  endeavored  to  show  that  of  100  persons,  only  four  reached  the  age  of 
thirty  years  witlioutliaving  it ;  that  one  in  seven  or  eight,  who  were  affected, 
died ;  and  that  of  those  who  were  attacked  in  infancy  only  two-thirds 
escaped.  Before  the  introduction  of  vaccination,  small-pox  was  infinitely 
more  destructive  to  human  life  than  the  plague  itself ;  it  lias  swept  away 
whole  tribes  of  savage  and  half  civilized  people,  and  its  miserable  victims 
have  been  abandoned  by  their  nearest  relatives  and  friend's,  as  persons 
doomed  by  divine  wrath  to  irrevocable  death  ;  it  was  calculated  that  210,000 
fell  victims  to  it  annually  in  Europe,  and  Bernouilli  believed  that  not  less 
than  fifteen  millions  of  human  beings  were  destroyed  by  small-pox  every 
twenty-five  years,  that  is  six  hundred  thousand  annually;  and  this  loath¬ 
some  disease  was  not  only  universal  in  its  ravages,  but  was  so  subtle  in 
its  influence  and  insidious  in  its  attack,  that  all  efforts  to  stay  its  violence 
or  to  prevent  its  approach,  were  utterly  futile.  Even  inoculation  whilst  it 
was  far  less  fatal  than  the  natural  small-pox  and  thus  benefited  the  indi¬ 
vidual,  tended  nevertheless  to  increase  the  spread  of  the  disease,  and  its 
extensive  adoption  wTas  attended  with  a  most  marked  increase  of  mortality 
of  the  disease  in  the  human  race. 

Sir  Matthew  Hale,  in  a  letter  of  advice  and  admonition  to  one  of  his  grand¬ 
sons,  has  given  an  excellent  picture  of  this  disease,  which  well  illustrates 


262 


Spurious  Vaccination:  Joseph  Jones ,  M.  I). 


its  odious  characters,  and  exhibits  the  impression  which  it  makes  on  the 
world  at  large,  in  a  stronger  light  than  if  the  description  had  been  drawn 
up  by  a  strictly  professional  hand. 

“First,  therefore,  touching  your  late  sickness  (small-pox)  I  would  have  you  remember  these  particulars  : 
1st.  The  disease  itself  in  its  own  nature  is  now  become  ordinarily  very  mortal,  especially  to  those  of  your 
age.  Look  upon  even  the  last  year’s  general  bill  of  mortality,  you  will  find  near  two  thousand  dead  of  that 
disease  ;  and,  had  God  not  been  merciful  to  you,  you  might  have  been  one  of  that  number  with 
as  great  likelihood  as  any  of  them  who  died  of  that  disease.  2d.  It  was  a  contagious  disease  that  se¬ 
cluded  the  access  of  your  nearest  relations.  3d.  Tour  sickness  surprised  you  upon  a  sudden,  when  you 
seemed  to  be  in  your  full  strength.  4th.  Tour  sickness  rendered  you  noisome  to  yourself  and  all  that  wer  e 
about  you;  and  a  spectacle  full  of  deformity,  by  the  excess  of  your  disease,  beyond  most  that  are  sick 
thereof.  5th.  If  was  a  fierce  and  violent  sickness  :  it  did  not  only  take  away  the  common  supplies  of  na¬ 
ture,  as  digestion,  sleep,  strength,  but  it  took  away  your  memory,  your  understanding  and  the  very  sense  of 
your  condition,  or  of  what  might  be  couducible  to  your  good.  All  that  you  could  do  was  only  to  make  your 
condition  more  desperate,  in  case  they  that  were  about  you  had  not  prevented  it  and  taken  more  care  for 
you  than  you  did  or  could  for  yourself.  6th.  Tour  sickness  was  desperate,  in  so  much  that  your  symptoms 
and  the  violence  of  your  distemper  were  without  example;  and  you  were  in  the  very  next  degree  to  ab- 
“sluto  rottenness,  putrefaction  and  death  itself.” 

By  the  unaided  efforts  of  a  man,  emulous  not  of  distinction  but  desirous 
of  advancing  truth,  and  promoting  the  happiness  and  well  being  of  his  fel¬ 
low  creatures,  and  distinguished  as  much  for  his  humility,  long  suffering 
and  perseverance,  as  for  his  unsurpassed  powers  of  practical  observation, 
the  world  has  been  furnished  with  the  means  of  completely  eradicating  this 
terrible  scourge,  by  substituting  the  same  disease  in  a  mild,  modified  form 
non-communicable  by  effluvia  and  capable  ot  affording  complete  immunity 
from  the  natural  small  pox. 

So  far,  therefore,  from  charging  the  accidents  which  we  are  about  to 
describe,  to  the  process  of  vaccination,  as  established  and  advocated  by 
E  luard  Jenner,  we  are  persuaded  that  a  very  large  part,  if  not  the  whole, 
of  these  distressing  accidents  and  failures,  are  to  be  ascribed  directly  or 
indirectly  to  the  ignorance,  and  inattention  of  those  who  practice  vaccina¬ 
tion.  We  have  no  more  sympathy  with  the  modern  opponents  of  vaccina¬ 
tion,  than  we  have  with  those  English  physicians  who  attempted  to  decry 
the  labors  and  to  steal  the  honest  dues  of  tlieir  immortal  countryman,  and 
who  condescended  to  such  low  expedients  as  to  caricature  the  process  of 
vaccination,  by  representing  the  human  vissage  under  its  effects,  in  the  act 
of  transformation  into  that  of  the  lower  animals,  the  cow  and  the  horse. 
And  we  would  heartily  endorse  any  public  enactment  which  would  guard 
in  a  proper  manner  the  process  of  vaccination  ;  and  at  the  present  time, 
some  of  the  older  European  edicts  upon  the  subject  of  vaccination,  as  those 
ot  the  Emperor  of  Russia  in  1811,  and  of  the  King  of  Wirtemburgh  in  1818, 
might  be  reenacted,  by  the  'General  and  State  Governments,  with  great 
benefit  to  the  people.  •  * 

If  the  profession  had  uniformly  adhered  to  the  advice  and  the  rules  estab¬ 
lished  by  the  illustrious  founder  of  vaccination,  we  would  have  been  spared 
the  vast  majority  of  the  unfortunate  accidents  which  tend  to  bring  this  the 
only  safeguard  against  the  small  pox,  into  disrepute. 

Dr.  Jenner  gave  the  most  minute  attention  to  every  deviation  from  the 
correct  progress  of  the  vacciue  vesicle,  to  the  state  of  the  virus  to  be  insert¬ 
ed,  to  the  condition  of  the  skin  of  the  person  about  to  be  vaccinated,  and 
to  the  character  ot  the  vesicle  itself;  and  so  early  as  the  year  1799,  had 
ascertained  by  the  clearest  evidence,  some  of  the  causes  of  accident  and 
failure,  which  had  been  confirmed  by  later  observations. 

He  showed  that  in  some  cases  the  system  was  not  rendered  totally  un¬ 
susceptible  to  the  variolous  contagion,  either  by  the  cow-pox  vaccination 
or  the  small  pox;  but  that  vaccination,  wlmn  properly  performed  with 
genuine  matter,  afforded  as  complete  protection  as  the  small  pox  itself.  He 
proved  that  by  inoculating  a  person  who  had  gone  through  the  cow-pox, 
with  variolous  matter,  it  was  possible  to  excite  a  local  vesication,  the  virus 
from  which  was  capable  of  producing  a  mild  but  efficacious  small  pox.  He 


2G3 


Spurious  Vaccination:  Joseph  Jones,  M.  D. 


farther  maintained  that  modifications  and  varieties  might  arise  iu  the  vac¬ 
cine  pustule,  and  that  these  varieties  were  such  as  to  produce  “  every  gra¬ 
dation  in  the  state  of  the  pustule,  from  that  slight  deviation  from  perfec¬ 
tion,  which  is  quite  immaterial,  up  to  that  point  which  affords  no  security 
at  all.”  He  held  that  fluid  taken  from  a  spurious  vaccine  pustule  can  pro¬ 
pagate  and  perpetuate  its  like,  and  even  if  it  be  taken  from  a  genuine  pus¬ 
tule  in  its  far-advanced  stages,  it  is  capable  of  producing  varieties  which 
will  be  permanent  if  we  continue  to  employ  it. 

Jenner  laid  great  stress  upon  the  herpetic  state  of  the  skin,  in  inducing 
deviation  in  the  normal  progress  of  the  vaccine  disease ;  but  every  devia¬ 
tion,  from  whatever  cause  it  may  have  arisen,  was  considered  by  him  of 
the  greatest  moment;  and  in  all  his  published  works,  as  well  as  in  his 
private  communications  and  letters,  he  never  failed  to  urge  the  importance 
of  the  most  scrupulous  attention  to  the  mode  of  propagation  and  to  the 
whole  progress  of  the  vaccine  disease. 

Thus  in  his  paper  on  the  “Varieties  and  Modifications  of  the  Vaccine 
Pustule,”  he  thus  urges  upon  the  pr>  fession  the  necessity  of  the  most 
careful  attention  to  this  important  subject : 

“  I  shall  conclude  this  paper  by  observing  that  although  vaccine  inoculation  does  not  inflict  a  severe  dis¬ 
ease.  but.  on  the  contrary,  produces  a  mild  affection,  scarcely  meriting  the  term  disease ,  yet,  nevertheless, 
the  inoculator  should  be  extremely  caref  ul  to  obtain  a  just  and  clear  conception  of  this  important  branch  of 
medical  science.  He  should  not  only  be  acquainted  with  the  laws  and  agencies  of  the  vaccine  virus  on  the 
constitution,  but  with  those  of  the  variolous  also,  as  they  often  interfere  with  each  other. 

“  A  general  knowledge  of  the  subject  is  not  sufficient  to  enable  us  to  warrant  a  person  to  practice  vaccine 
inoculation:  he  should  possess  a  peculiar  knowledge  ;  and  that  which  I  would  wish  strongly  to  inculcate,  as 
the  great  foundation  of  the  whole,  is  an  intimate  acquaintance  with  the  character  of  the  true  and  genuine 
pustule.  The  spurious  pustule  would  then  be  readily  detected,  whatever  form  it  might  assume  ;  and  errors 
known  no  more.” 

Dr.  Jenner,  in  a  letter  written  to  Sir  Gilbert,  near  the  close  of  his  life, 
reiterates  these  precautions,  and  observes  : 

“  With  regard  to  the  mitigated  disease  which  sometimes  follows  vaccination,  I  can  positively  say,  and 
shall  be  borne  out  in  my  assertion  by  those  who  are  in  future  days  to  follow  me,  that  it  is  the  offspring  en¬ 
tirely  of  incaution  in  those  who  conduct  the  vaccine  process.  On  what  does  the  inexplicable  change  which 
guards  the  constitution  from  the  fang  of  the  small-pox  depend?  On  nothing  but  a  correct  state  of  the  pus¬ 
tule  on  the  arm  excited  by  the  insertion  of  the  virus  ;  and  why  are  these  pustules  sometimes  incorrect,  los. 
ing  their  characteristic  shape,  and  performing  their  offices  partially  ?  " — Life  of  Edward  Jenner ,  if.  D. 
etc.,  by  John  Baron,  if.  D. ;  vol.  2,  p.  241. 

Jenner  even  went  so  far  as  to  maintain  that  the  process  of  vaccination 
might  be  rendered  ineffective  by  mechanically  disturbing  the  vesicle,  during 
the  collection  and  transmission  of  the  virus,  and  he  insisted  upon  the  ne¬ 
cessity  of  allowing  one  vesicle  at  least  to  run  its  course  undisturbed. 

So  far,  therefore,  from  desiring  to  injure  the  cause  of  vaccination  by  the 
record  of  distressing  failures  and  accidents,  it  will  be  our  endeavor,  rather 
in  the  spirit  of  Jenner,  to  guard  the  process,  by  so  exposing  the  cause  of 
these  accidents  as  to  lead  to  their  avoidance  in  future. 

“  hire  I  proceed,  let  me  be  permitted  to  observe,  that  truth  in  this,  and 
every  other  physiological  inquiry  that  has  occupied  my  attention,  lias  ever 
been  the  first  object  of  my  pursuit ;  and  should  it  appear  in  the  present  in¬ 
stance  that  I  have  been  led  into  error,  fond  as  1  may  appear  of  the  off¬ 
spring  of  my  labors,  I  had  rather  see  it  perish  at  once  than  exist  and  do  a 
public  injury.” 


264 


Spurious  Vaccination:  Joseph  Jones ,  M.  D. 


SECTION  II.— MODIFICATION,  ALTERATION  AND  DEGENERA¬ 
TION  OF  THE  VACCINE  VESICLE,  DEPENDENT  UPON  DE¬ 
PRESSED  AND  DERANGED  FORCES,  RESULTING'  FROM 
FATIGUE,  EXPOSURE  AND  POOR  DIET;  AND  UPON  AN 
IMPOVERISHED,  VITIATED  AND  SCORBUTIC  CONDITION 
OF  THE  BLOOD  OF  THE  PATIENTS  VACCINATED  AND 
YIELDING  VACCINE  MATTER.  IN  SCORBUTIC  PATIENTS 
ALL  INJURIES  OF  THE  SKIN  TEND  TO  FORM  ULCERS  OF 
AN  UNHEALTHY  CHARACTER.  EFFECTS  OF  SCURVY 
UPON  THE  CHARACTER  AND  PROGRESS  OF  THE  VAC¬ 
CINE  VESICLE.— INVESTIGATIONS  UPON  THE  EFFECTS 
OF  VACCINATION  AMONGST  THE  FEDERAL  PRISONERS 
CONFINED  IN  CAMP  SUMPTER,  ANDERSONVILLE,  GA. 
EXAMINATION  OF  THE  CHARGE  URGED  BY  THE  UNITED 
STATES  MILITARY  COMMISSION,  THAT  THE  CONFEDERATE 
SURGEONS  DELIBERATELY  POISONED  OR  DESTROYED 
THE  FEDERAL  PRISONERS  AT  ANDERSONVILLE  WITH 
POISONOUS  VACCINE  MATTER.  DR.  HAMILTON  ON  SPUR¬ 
IOUS  VACCINATION  IN  THE  U.  S.  ARMY.  DR.  L.  GUILD 
ON  THE  MEDICAL  RECORDS  OF  THE  ARMY  OF  NORTH¬ 
ERN  VIRGINIA.  REPOLTS  ON  SPURIOUS  VACCINATION 
IN  THE  CONFEDERATE  ARMY,  BY  S.  E.  HABERSHAM,  M. 
D.,  OF  AUGUSTA,  GEORGIA,  AND  OTHER  CONFEDERATE 
OFFICERS. 

Large  numbers  of  the  Coufederate  soldiers  manifested  slight  scorbutic 
symptoms,  which  were  not  sufficient  to  attract  attention,  or  to  induce 
treatment,  and  as  far  as  we  could  learn,  no  attention  was  paid  to  this  con¬ 
dition  either  in  vaccination  or  in  the  selection  of  the  vaccine  lymph. 

In  scorbutic  patients,  all  injuries  tended  to  form  ulcers  of  an  unhealthy 
character,  and  the  vaccine  vesicles  even  when  they  appeared  at  the  proper 
time,  and  manifested  many  of  the  usual  symptoms  of  the  vaccine  disease, 
were  nevertheless  larger  and  more  slow  in  healing,  and  the  scabs  presented 
an  enlarged,  scaly,  dark,  unhealthy  appearance.  In  many  cases  a  large 
ulcer,  covered  with  a  thick  laminated  crust,  from  one-quarter  to  one  inch 
in  diameter,  followed  the  introduction  of  the  vaccine  matter  into  scorbutic 
patients.  Matter  from  these  scabs  and  sores  was  frequently  used  in  vacci¬ 
nation,  and  this  decomposing  pus  and  blood  acted  as  an  animal  poison  in 
some  cases,  and  especially  in  constitutions  debilitated  by  exposure,  fatigue 
and  salt  diet. 

During  the  prosecution  of  the  investigations  which  we  instituted  upon 
the  diseases  of  the  Federal  prisoners  confined  at  Andersonville,  the  oppor¬ 
tunity  was  embraced  of  investigating  the  remarkable  effects  which  followed 
the  attempts  of  the  Confederate  medical  officers  to  arrest  the  spread  of 
small-pox  by  vaccination.  In  a  number  of  cases  large  gangrenous  ulcers 
appeared  at  the  points  where  the  vaccine  lymph  had  been  inserted,  caus¬ 
ing  extensive  destruction  of  tissues,  exposing  arteries,  nerves  and  bones, 


Spurious  Vaccination:  Joseph  Jones ,  M.  D. 


265 


and  necessitating  amputation  in  more  than  one  instance.  These  accidents 
led  to  the  belief  amongst  some  of  the  prisoners  that  the  surgeons  had  in¬ 
tentionally  introduced  poisonous  matter  into  their  arms  during  vaccination  • 

j4fter  careful  inquiry  we  were  led  to  the  conclusion  that  these  accidents 
were,  in  the  case  of  these  Federal  prisoners,  referable  wholly  to  the  scor¬ 
butic  condition  of  their  blood,  and  to  the  crowded  condition  of  the  stockade 
and  hospital.  The  smallest  accidental  injuries  and  abrasions  of  the  sur¬ 
face,  as  from  splinters,  or  bites  of  insects,  were  in  a  number  of  instances 
followed  by  such  extensive  gangrene  as  to  necessitate  amputation.  The 
gangrene  following  vaccination  appeared  to  be  due  essentially  to  the  same 
cause ;  and  in  the  condition  of  the  blood  of  these  patients,  would  most 
probably  have  attacked  any  puncture  made  by  a  lancet,  without  any  vac¬ 
cine  matter  or  any  other  extraneous  material.  It  appeared  also  that  the 
dried  scab,  resulting  from  the  vaccination  of  these  scorbutic  patients,  was 
also  capable  of  producing  effects  wholly  different  from  the  vaccine  lymph 
of  healthy  individuals;  and  in  some  cases  these  effects  were  of  a  most  po¬ 
tent  and  injurious  character. 

The  cause  of  Justice  and  Truth  demands,  at  my  hands,  something 
more  than  this  simple  record,  with  reference  to  the  accidents  following  vac¬ 
cination  amongst  the  Federal  prisoners  confined  in  Camp  Sumpter. 

In  the  specification  vof  the  first  charge  against  Henry  Wirz,  formerly 
Commandant  of  the  interior  of  the  Confederate  States  Military  Prison,  dur¬ 
ing  his  Trial  before  a  Special  Military  Commission ,  convened  in  accordance 
with  Special  Orders  Ho.  453,  War  Department,  Adjutant  General’s  Office, 
Washington,  August  23,  1865,  the  following  is  written: 

“  And  the  said  Wirz,  still  pursuing  his  wicked  purpose,  aud  still  aiding  in  carrying  out- 
said  conspiracy,  did  use  and  cause  to  be  used,  for  t-be  pretended  purpose  of  vaccination, 
impure  and  poisonous  matter,  which  said  impure  and  poisonous  matter  was  then  and 
there,  by  the  direction  and  order  of  said  Wirz,  maliciously,  cruelly,  and  wickedly  depos¬ 
ited  in  the  arms  of  said  prisoners,  by  reason  of  which  large  numbers  of  them,  to-wit,  one 
hundred,  lost  the  iise  of  their  arms,  and  many  of  them,  about  the  number  of  two  hun¬ 
dred,  were  so  injured  that  they  soon  thereafter  died  :  All  of  which  he,  the  said  Henry 
Wirz,  well  knew  and  maliciously  intended,  and  in  aid  of  the  then  existing  rebellion 
against  the  United  States,  with  the  view  to  assist  in  weakening  and  impairing  the  armies 
of  the  United  States,  and  in  furtherance  of  said  conspiracy,  and  with  full  knowledge, 
consent  and  connivance  of  his  co-conspirators  aforesaid,  he,  the  said  Wirz,  then  and 
there  did.” 

Amongst  tfie  co-conspirators  specified  in  the  charges,  were  the  Surgeon 
of  the  Post,  Dr.  White,  and  the  Surgeon  in  charge  of  the  Military  Prison 
Hospital,  If.  E.  Stevenson.  As  ths  vaccinations  were  made  by  their  orders, 
and  by  the  medical  officers  of  the  Confederate  Army,  acting  under  their 
command,  the  charge  of  deliberately  poisoning  the  Federal  prisoners  with 
vaccine  matter  was  a  sweeping  one,  and  whether  intended  so  or  not,  affects 
every  medical  officer  stationed  at  that  post ;  and  it  appears  to  have  been 
designed  to  go  farther  and  affect  the  reputation  of  every  one  who  held  a 
commission  in  the  Medical  Department  of  the  Confederate  Army. 

The  acts  of  those  who  once  composed  the  Medical  Department  of  the 
Confederate  Army,  from  the  efficient  and  laborious  Surgeon  General  to  the 
Eegimental  officers,  need  no  defence  at  my  hands  ;  time,  with  its  unerring 
lines  of  historic  truth,  will  embalm  their  heroic  labors  in  the  cause  of  suf¬ 
fering  humanity,  and  will  acknowledge  their  untiring  efforts  to  ameliorate 
the  most  gigantic  mass  of  suffering,  that  ever  fell  to  the  lot  of  a  be¬ 
leaguered  and  distressed  people. 

I  desire  at  the  present  time,  sirnplv  to  place  on  record,  the  results  of 
labors  which  concern  this  country,  no  more  than  any  other;  and  the  results 
when  properly  received  without  prejudice  or  malicious  hatred,  will  be  seen 


266 


Spurious  Vaccination:  Joseph  Jones,  M.  D. 


to  relate  to  the  hygiene  and  to  the  diseases  of  prisoners,  however  confined, 
and  wherever  incarcerated,  in  civil  or  military  prisons  throughout  the 
world. 

In  accordance  with  the  direction  of  Dr.  Samuel  Preston  Moore,  formerly 
Surgeon  General  G.  S.  A.,  I  instituted  during  the  months  of  August  and 
September.  1864,  a  series  of  investigations  upon  the  diseases  of  Federal 
prisoners  confined  in  Camp  Sumpter,  Andersonville,  Georgia. 

The  field  was  of  great  extent  and  of  extraordinary  importance.  There 
were  more  than  five  thousand  seriously  sick  in  the  hospital  and  stockade, 
and  the  deaths  ranged  from  ninety,  to  one  hundred  and  thirty,  each  day. 
From  the  establishment  of  the  prison,  on  the  twenty-fourth  day  of  Feb 
ruary,  1864,  to  the  first  of  October  over  ten  thousand  Federal  prisoners 
died  ;  that  is,  near  one-third  of  the  entire  number  perished  in  less  than 
seven  morths.  I  instituted  careful  investigations  into  the  condition  of  the 
sick  and  well,  and  performed  numerous  post-mortem  examinations,  and  exe¬ 
cuted  drawings  of  the  diseased  structures.  The  medical  topography  of 
Andersonville  and  of  the  surrounding  country  was  examined,  and  the 
waters  of  the  streams,  springs  and  wells,  around  and  within  the  stockade 
and  hospital  carefully  analyzed. 

The  report  which  I  drew  up  for  the  use  of  the  Medical  Department  of 
the  Confederate  Army,  contained  a  truthful  representation  of  the  sufferings 
of  these  prisoners,  and  at  the  same  time  gave  an  equally  truthful  view  of 
the  difficulties  under  which  the  medical  officers  labored,  and  of  the  dis¬ 
tressed  and  beleaguered  and  desolated  condition  of  the  Southern  States. 
Shortly  after  the  close  of  the  civil  war,  this  report,  which  had  never  been 
delivered,  on  account  of  the  destruction  of  all  railroad  communication  with 
Richmond,  Virginia,  was  suddenly  seized  by  the  agents  of  the  United 
States  government,  conducting  the  trial  to  which  we  have  alluded.* 

It  was  with  extreme  pain  that  I  contemplated  the  diversion  of  my  labors 
in  the  cause  of  medical  science,  from  their  true  and  legitimate  object,  and 
I  addressed  an  earest  appeal,  which  accompanied  the  report,  to  the  J  udge 
Advocate,  Colonel  N.  P.  Ohipman,  in  which  I  used  the  following  language : 

In  justice  to  myself,  as  well  as  to  those  most  nearly  connected  with  this  investigation, 
I  would  respectfully  call  the  attention  of  Colonel  Chipman,  Judge  Advocate  U.  S.  A., 
to  the  fact  that  the  matter  which  is  surrendered  in  obedience  to  the  demands  of  a  power 
from  which  there  is  no  appeal,  was  prepared  solely  for  the  consideration  of  the  Surgeon 
General,  C.  S.  A.,  and  was  designed  to  promote  the  cause  of  humanity,  and  to  advance 
the  interests  of  the  medical  profession.  This  being  granted,  I  feel  assurred  that  the 
Judge  Advocate  will  appreciate  the  deep  pain  which  the  anticipation  gives  me  that  these 
labors  may  be  diverted  from  the  original  mission,  and  applied  to  the  prosecution  of  crim¬ 
inal  cases.  The  same  principle  which  led  me  to  endeavor  to  deal  humanely  and  justly 
by  these  suffering  prisoners,  and  to  make  a  truthful  represents  ion  of  their  condition  to 
the  Medical  Department  of  the 'Confederate  Army,  now  actuates  me  in  recording  my  be¬ 
lief  that  as  far  as  my  knowledge  extends,  there  was  no  deliberate  or  willful  design  on  the 
part  of  the  Chief  Executive,  Jefferson  Davis,  and  the  highest  authorities  of  the  Confed¬ 
erate  Government  to  injure  the  health  and  destroy  the  lives  of  these  Federal  prisoners. 

On  the  twenty-ffrst  of  May,  1861,  it  was  enacted  by  the  “  Congress  of  the  Confederate 
States  of  America,”  “That  all  prisoners  of  war  taken,  whether  on  land  or  at  sea,  during 
the  pending  hostilities  with  the  United  States,  should  be  transferred  by  the  captors, 
from  time  to  time,  as  often  as  convenient,  to  the  Department  of  War  ;  and  it  shall  be  the 
duty  of  the  Secretary  oi  War,  with  the  approval  of  the  President,  to  issue  such  instruc¬ 
tions  to  the  Quartermaster  General  and  his  subordinates,  as  shall  provide  for  the  safe 
custody  and  sustenance  of  prisoners  of  war  ;  and  the  rations  furnished  prisoners  of  war 
shall  be  the  same  in  quantity  and  quality  as  those  furnished  enlisted  men  in  the  army  of 
the  Confederacy.”  liy  act  of  February  17,  1864,  the  Quartermaster  General  was  relieved 
of  this  duty,  and  the  Commissary  General  of  Subsistence  was  ordered  to  provide  for  the 
sustenance  of  prisoners  of  war. 


*1  have  since  learned  that  the  United  States  authorities  gained  knowledge  of  thefact  that  Iliad  inspected 
Andersonville  through  information  furnished  by  ^distinguished  member  of  the  medical  profession  of  the 
North,  who,  after  the  close  of  the  war,  had  shared  the  hospitality  of  my  own  home. 


Spurious  Vaccination :  Joseph  Jones ,  71  f.  I). 


267 


According  to  General  Orders  No.  159,  Adjutant  and  Inspector’s  General’s  Office,  “  hos¬ 
pitals  for  prisoners  of  war  are  placed  on  the  same  footing  as  other  Confederate  States 
hospitals,  in  all  respects,  and  will  be  managed  accordingly.” 

The  Federal  prisoners  were  removed  to  Southwestern  Georgia  in  the  early  part,  of  1864, 
not  only  to  secure  a  confinement  more  remote  than  Richmond  and  other  large  towns, 
from  the  operations  of  the  United  States  forces,  but  also  to  secure  a  more  abundant  and  easy 
supply  of  food. 

As  far  as  my  experience  extends,  no  person  who  had  been  reared  upon  wheat  bread, 
and  who  was  held  in  captivity  for  any  length  of  time,  could  retain  his  health  and  escape 
either  scurvy  or  diarrhoea,  if  confined  to  the  Confederate  ration  (issued  to  the  soldier  in 
the  field  and  hospital)  of  unbolted  corn  meal  and  bacon.  The  large  armies  of  the  Con¬ 
federacy  suffered  more  than  once  from  scurvy,  and  as  the  war  progressed,  secondary 
hemorrhage  and  hospital  gangrene  became  fearfully  prevalent,  from  the  deteriorated  con¬ 
dition  of  the  systems  of  the  troops,  dependent  upon  I  he  prolonged  use  of  salt  meat.  And 
but  for  the  extra  supplies  received  from  home  and  from  the  various  benevolent  institu¬ 
tions,  scurvy  and  diarrhoea  and  dysentery  would  have  been  still  farther  prevalent.” 

It  was  believed  by  the  citizens  of  the  Southern  States,  that  the  Confederate  authorities 
desired  to  effect  a  continuous  and  speedy  exchange  of  prisoners  of  war  in  their  hands,  on 
the  ground  that  the  retention  of  these  soldiers  in  captivity  was  a  great  calamity,  not 
only  entailing  heavy  expenditure  of  the  scanity  means  of  subsistence,  already  insuffi¬ 
cient  to  support  their  suffering,  half-starved,  half-clad  and  unpaid  armies,  struggling  in 
the  field  with  overwhelming  numbers,  and  embarrassing  their  imperfect  and  dilapidated 
lines  of  communication  ;  but  also  as  depriving  them  of  the  services  of  a  veteran  army 
fully  equal  to  one-third  the  numbers  actively  engaged  in  the  field;  and  the  history  of 
subsequent  events  have  shown  that  the  retention  in  captivity  of  the  Confederate  prison¬ 
ers  was  one  of  the  efficient  causes  of  the  final  and  complete  overthrown  of  the  Confeder¬ 
ate  Government.  *  *  * 

It  is  my  honest  belief  that  if  the  exhausted  condition  of  the  Confederate  Government, 
with  its  bankrupt  currency,  with  its  retreating  and  constantly  dimishing  armies,  with 
the  apparent  impossibility  of  filling  up  the  vacancies  by  death  and  desertion  and  sick¬ 
ness,  and  of  gathering  a  guard  of  reserve  of  sufficient  strength  to  allow  of  the  proper 
enlargement  of  the  Military  Prison,  and  with  a  country  torn  and  bleeding  along  all  its 
borders  with  its  starving  women  and  children  and  old  men  fleeing  from  the  desolating 
march  of  contending  armies,  crowding  the  dilapidated  and  over-burdened  railroad  lines, 
and  adding  to  the  distress  and  consuming  the  poor  charities  of  those  in  the  interior,  who 
were  harrassed  by  the  loss  of  sons  and  brothers  and  husbands,  and  by  the  fearful  visons 
of  starvation  and  undefined  misery,  could  be  fully  realized,  much  of  the  suffering  of  the 
Federal  prisoners  would  be  attributed  to  causes  connected  with  the  distressed  condition 
of  the  Southern  States. 

Tim  grand  object  of  the  trial  and  conviction  of  Henry  Wirz  was  the  con¬ 
viction  and  execution  of  President  Davis,  Gen.  Robert  E.  Lee  and  other 
prominent  men  of  the  Confederacy,  in  order  that  “  treason  might  be 

RENDERED  FOREVER  ODIOUS  AND  INFAMOUS.” 

The  Judge  Advocate,  N.  P.  Chipman,  Colonel  TJ.  S.  A.,  was  not  only 
deaf  to  this  appeal,  but  in  his  final  argument  before  “  The  Military  Com¬ 
mission ]”  or  so-called  u  Court”  whilst  excluding  all  portions  of  my  testi¬ 
mony  which  related  to  the  distressed  condition  of  the  Southern  States,  and 
the  efforts  of  the  medical  officers  and  Confederate  authorities  to  relieve  the 
sufferings  of  the  prisoners  of  war,  deliberately  endeavored  to  arouse  the 
hatred  of  the  entire  North  against  the  author  ot  the  report  and  the  medical 
officers  of  the  Confederate  army. 

This  statement  will  be  sustained  by  the  following  quotation,  which  I 
extract  from  the  u  argument”  of  the  Judge  Advocate  before  the  Court:” 

“  He  had  called  into  his  counsels  an  eminent  medical  gentleman,  of  high  attainments 
in  his  profession,  and  of  loyalty  to  the  rebel  Government  unquestioned.  Amid  all  the 
details  in  this  terrible  tragedy,  there  seems  to  me  none  more  heartless,  wanton  and  void 
of  humanity  than  that  revealed  by  the  Surgeon  General,  to  which  I  am  about  to  refer. 
I  quote  now  from  the  report  of  this  same  Dr.  Joseph  Jones,  which  he  says  (Record,  p. 
4384,)  was  made  in  the  interest  of  the  Confederate  Government,  for  the  use  of  the  Medi¬ 
cal  Department,  in  the  view  that  no  eye  would  ever  see  it  but  that  of  the  Surgeon 
General. 

‘ ‘  After  a  brief  introduction  to  his  report,  and  to  show  under  what  authority  it  was 
made,  he  quotes  a  letter  from  fhe  Surgeon  General,  dated  ‘Surgeon  General’s  Office, 
Richmond,  Virginia,  August  6,  1864.’  The  letter  is  addressed  to  Surgeon  .T.  II.  V  bite, 
in  charge  of  the  hospital  for  Federal  prisoners,  Andersouville,  Georgia,  and  is  as  follows: 


268 


Spurious  Vaccination :  Joseph  Jones ,  M.  I). 


“Sir — The  field  of  pathological  investigation,  afforded  by  the  large  collection  of  Fed¬ 
eral  prisoners  in  Georgia,  is  of  great  extent  and  importance,  and  it  is  believed  that  re¬ 
sults  of  value  to  the  profession  may  be  obtained  by  careful  examination  of  the  effects  of 
disease  upon  a  large  body  of  men,  subjected  to  a  decided  change  of  climate,  and  the  cir¬ 
cumstances  peculiar  to  prison  life.  The  surgeon  in  charge  of  the  hospital  for  Federal 
prisoners,  together  with  his  assistants,  will  afford  every  facility  to  Surgeou  Joseph  Jones 
in  the  prosecution  of  the  labors  ordered  by  the  Surgeon  General.  The  medical  officers 
will  assist  in  such  post  mortems  as  Dr.  Joseph  Jones  may  indicate,  in  order  that  this 
great  field  for  pathological  investigation  may  be  explored  for  the  benefit  of  the  Medical 
Department  of  the  Confederate  States.  S.  P.  MOORE,  Surgeon  General. 

“  Pursuant  to  his  orders  Dr.  Jones,  as  he  tells  us,  proceeded  to  Anderson  ville,  and  ou 
September  17  received  the  following  pass: 

‘Andersonvillk,  September  17,  1864. 

•  To  Captain  H.  Wirz,  Commanding  Prison  : 

‘  Captain — You  will  perm  t  Surgeon  Joseph  Jones,  who  has  orders  from  the  Surgeon 
General,  to  visit  the  sick  within  the  stockade  that  are -under  medical  treatment.  Sur¬ 
geon  Jones  is  ordered  to  make  certain  investigations,  wdiich  may  prove  useful  to  liis 
profession.  Very  respectfully, 

‘  By  order  of  Gen.  Winder  W.  S.  WINDER,  A.  A.  G.’ 

“  When  we  remember  that  the  Surgeon  General  had  been  apprised  of  the  wants  of  that 
prison,  and  that  he  had  overlooked  the  real  necessities  of  the  prison,  shifting  the  respon¬ 
sibility  upon  Dr.  White,  whom  he  must  have  known  was  totally  incompetent,  it  is  hard 
to  conceive  with  what  devilish  malice,  or  criminal  devotion  to  his  profession,  or  reckless 
disregard  of  the  high  duties  imposed  upon  him — I  scarcely  know  which — he  could  sit 
down  and  deliberately  pen  such  a  letter  of  instructions  as  that  given  Dr  Jones. 

“Was  it  not  enough  to  have  cruelly  starved  and  murdered  our  soldiers?  Was  it  not 
enough  to  have  sought  to  wipe  out  their  very  memories  by  burying  them  in  nameless 
graves?  Was  it  not  enough  to  have  instituted  a  system  of  medical  treatment  the  very 
embodiment  of  cliarlatism  ?  Was  it  not  enough  without  adding  to  the  many  other  dia¬ 
bolical  motives,  which  must  have  governed  the  perpetrators  of  these  acts,  this  scientific 
object,  as  deliberate  and  cold-blooded  as  one  can  conceive?  The  Surgeon  General  could 
quiet  his  conscience,  when  the  matter  was  laid  before  him  by  Colonel  Chandler,  by  in¬ 
dorsing  that  it  was  impossible  to  send  medical  officers  to  take  the  place  of  the  contract 
physicians  on  duty  at  Andersonville,  yet  could  select  at  the  same  time  a  distinguished 
gentleman  of  the  medical  profession  and  send  him  to  Andersonville,  directing  the  whole 
force  of  surgeons  there  to  render  him  every  assistance,  leaving  their  multiplied  duties  for 
that  purpose.  Why?  Not  to  alleviate  the  sufferings  of  the  prisoners ;  not  to  convey  to 
them  one  ounce  more  of  nutritious  food ;  to  make  no  suggestions  for  the  improvement  of 
their  sanitary  condition — for  no  purpose  of  this  kind,  but  as  the  letter  of  instruction 
itself  shows,  for  no  other  purpose  than  that  this  great  field  of  pathological  investigation 
may  be  explored  for  the  benefit  of  the  Medical  Department  of  the  Confederate  Armies.” 

The  denunciations  of  the  Judge  Advocate  were  leveled,  not  merely 
against  a  defenseless  prisoner  of  war,  whose  papers  had  been  seized,  and 
himself  dragged  as  a  witness  to  this  crucifixion  of  his  native  land,  but  they 
were  sweeping  in  their  character,  and  were  designed  to  arraign  the  hu¬ 
manity,  honesty  and  intelligence  of  the  Surgeon  General  and  the  entire 
corps  of  the  medical  officers  of  the  Confederate  Army. 

The  charge  had  the  desired  effect,  and  was  reiterated  even  by  eminent 
medical  men  of  the  North.  Thus  the  son  of  the  Vice  President  of  the 
United  States,  Ur.  Augustus  0.  Hamlin,  late  Medical  Inspector  U.  S.  A., 
Royal  Antiquarian,  etc.,  etc.,  in  his  Martyria  or  Andersonville  Prison ,  says  : 

“  Here  came  a*meclical  officer  of  the  liigbest  rank  in  the  rebel  army,  and  one  of  the 
most  eminent  savans  of  the  South,  to  study  the  philosophy  and  physiology  of  starvation. 

“  The  notes  of  that  fearful  clinic  are  preserved,  and  may,  some  future  day,  startle  the 
scientific  world  with  their  clearness,  their  candor,  their  positive  evidence  of  the  cause 
of  death.  Thus  the  scalpel  silences  the  arguments  and  reasonings  of  sophistry.” 

A  similar  statement  has  been  made  by  Ur.  Austin  Flint,  Jr.,  in  his  recen 
work  on  the  Physiology  of  Man. 

It  was  clearly  demonstrated  in  my  report  that  diarrhoea,  dysentery,  scurvy, 
and  hospital  gangrene  were  the  diseases  which  caused  the  extraordinary 
mortality  of  Andersonville.  And  it  was  still  further  shown  that  this  mor¬ 
tality  was  referable,  in  no  appreciable  degree,  to  either  the  character  of 
the  soil,  or  waters,  or  the  conditions  of  climate. 


269 


Spurious  Vaccination:  Joseph  Jones,  M.  D. 


The  effects  ot  salt  meat  and  farinaceous  food,  without  fresh  vegetables, 
were  manifest  in  the  great  prevalence  of  scurvy.  The  scorbutic  condition 
thus  induced  modified  the  course  of  every  disease,  poisoned  every  wound, 
however  slight,  and  lay  at  the  foundation  of  those  obstinate  and  exhaust¬ 
ing  diarrhoeas  and  dysenteries,  which  swept  off  thousands  of  these  unfor¬ 
tunate  men.  By  a  long  and  painful  investigation  of  the  diseases  of  these 
prisoners,  supported  by  numerous  post-mortem  examinations,  I  demon¬ 
strated  conclusively  that  scurvy  induced  nine-tenths  of  the  deaths.  Not 
only  were  the  deaths  registered  as  due  to  unknown  causes,  to  apoplexy,  to 
anasarca,  and  to  debility,  directly  traceable  to  scurvy  and  its  effects,  and 
not  only  was  the  mortality  in  small-pox,  and  pneumonia  and  typhoid  fever, 
and  in  all  acute  diseases  more  than  doubled  by  the  scorbutic  taint,  but  even 
those  all  but  universal  and  deadly  bowel  affections,  arose  from  the  same 
causes,  and  derived  their  fatal  characters  from  the  same  conditions  which 
produced  the  scurvy. 

Scurvy  and  hospital  gangrene  frequently  exist  in  the  same  individual. 
In  such  cases,  vegetable  diet,  with  vegetable  acids,  would  remove  the  scor¬ 
butic  condition  without  curing  the  hospital  gangrene.  It  has  been  well 
established  by  the  observations  of  Blane,  Trotter  and  others,  that  the  scor¬ 
butic  condition  of  the  system,  especially  in  crowded  camps,  ships,  hospitals 
and  beleaguered  cities,  is  most  favorable  to  the  origin  and  spread  of  foul 
ulcers  and  hospital  gangrene.  In  many  cases  occurring  amongst  the  Fed¬ 
eral  prisoners  at  Andersonville,  it  was  difficult  to  decide  at  first  whether 
the  ulcer  was  a  simple  result  of  the  scorbutic  state,  or  of  the  action  of  the 
poison  of  hospital  gangrene.  So  commonly  have  these  two  diseases  been 
combined,  that  the  description  of  scorbutic  ulcers  by  many  authorities,  ev¬ 
idently,  includes  also  many  of  the  prominent  characteristics  of  hospital 
gangrene,  as  will  be  seen  by  a  reference  to  the  descriptions  of  Lind,  Trotter, 
Blane  and  others. 

More  than  two  hundred  and  fifty  years  ago,  Bard  described  a  condition 
of  things  similar  to  that  of  Andersonville  ;  at  the  siege  of  Rouen,  the  air 
was  so  noxious  that  no  wounds  would  heal,  and  the  besieged  finding  that 
all  their  wounds  became  gangrenous,  reported  that  the  besiegers  had 
poisoned  the  balls;  the  besiegers  also  seeing  none  but  putrid  sores  in  the 
camp,  believed  that  the  wounds  were  poisoned,  and  both  within  and  with¬ 
out  the  city  such  was  the  state  of  the  air,  and  so  putrid  were  all  the  wounds, 
that  the  surgeons  could  scarcely  look  upon  the  sores,  or  endure  the  smell  ; 
and  if  they  neglected  them  for  a  single  day,  they  found  them  filled  with 
worms 

Woodall,  in  his  Chirurgeons  Mate ,  or  Military  and  Domestic  Surgery ,  pub¬ 
lished  in  1639,  not  only  carefully  describes  serobutic  ulcers,  but  also  lays 
down  rules  for  their  treatment ;  and  Gideon  Harvey,  twenty-four  years  laler. 
in  his  “  Venus  Unmasked ,”  mentions  superficial,  profound,  simple,  inflamed, 
callous,  dry,  sanious,  purulent,  phagedenick,  and  gangrenous  ulcers,  as 
characteristic  of  scurvy.  This  last  named  author  derives  the  name  scurvy 
from  “Scorbeck,  and  that  from  Scornobocca,  or  Fowl  mouth,  (from  Scorno 
a  Fowl  or  shameful  thing,  and  bocca  the  mouth),  for  a  stinking  breath  and 
fowl  rotten  gums,  may  still  be  termed  a  foul  or  shameful  mouth  ;  they  call 
it  also  La  marcia  di  bocca,  or  putrefaction  of  the  mouth.” — p.24. 

The  British  seamen,  in  Lord  Anson’s  voyage,  and  in  fact  in  all  long  voy¬ 
ages,  before  the  mode  of  preventing  scurvy  was  practiced,  suffered  terribly 
from  scorbutic  ulc(  rs. 

John  Huxham  in  his  Essay  on  Fevers,  in  a  chapter  in  which  he  discourses 
on  the  “disordered  and  putrid  state  of  the  blood,”  observes  that  the 


270 


Spurious  Vaccination :  Joseph  Jones,  M.  I). 


“  Salt  and  half-rotten  provisions  of  sailors  in  long  voyages,  cause  such  a  sharpness  and 
corruption  of  the  humors  that  they  are  rendered  almost  unfit  for  the  common  uses  of  life, 
producing  great  weakness,  langour,  wandering  pains  and  aches,  stinking  breath,  corroded, 
spongy  gums,  black,  blue,  and  sallow  spots,  sordid,  dark,  livid  fungous  ulcers,  gangrene, 
etc.,  etc.  Such  scorbutics  frequently  fall  into  patecheal  fevers,  bloody  dysenteries,  hem¬ 
orrhages,  etc.  What  is  mentioned  by  the  Rev.  Mr.  Walter  in  Lord  Anson’s  voyage,  is  very 
surprising,  viz.  ;  that  the  blood  hurst  from  the  wounds  of  some  of'  the  scorbutics  after 
they  had  been  cicatrifled  for  twenty  or  thirty  years.  I  have  known  many  a  ship’s  com¬ 
pany  set  out  on  a  cruise  in  high  health,  and  yet  in  two  or  three  months,  return  vastly 
sickly,  and  eat&n  out  with  the  scurvy,  a  third  part  of  them  half  rotteu,  aud  utterly  unfit 
for  service.  About  four  or  five  weeks  after  they  had  been  out,  they  begin  to  drop  down, 
one  after  another,  and  at  length  by  dozens,  till  at  least  scarce  half  the  compliment  can 
stand  to  their  duty;  particularly  I  remember  some  years  since,  from  a  squadron  under 
Admiral  Martin,  we  had  near  1200  men  put  on  the  shore  sick  at  one  time,  though  they 
went  out  very  healthy  and  returned  in  about  twelve  or  thirteen  weeks*”— p.  47. 

Dr.  Jolm  Hunter,  Surgeon  of  the  English  Army,  in  his  “Observations  on 
the  Diseases  of  the  Army  in  Jamaica,”  states  that 

“  Sores  and  ulcers  in  the  lower  extremities,  were  frequent  at  all  seasons  of  the  year, 
and  in  all  the  different  quarters  were  the  soldiers  were  stationed.  They,  together  with 
fevers  and  fluxes,  amounted  to  nineteen-twentieths  of  the  sick  received  iuto  the  hospitals, 
all  other  complaints  not  being  more  than  one-twentieth,  if  particular  times  be  excepted, 
when  the  dry-belly-ache  or  small-pox  were  prevalent.  The  proportion  of  sores  in  the 
hospitals,  though  always  considerable,  admitted  of  great  variation.  At  Spanish  Town  aud 
Kingston  they  were  often  one  third  ;  at  Fort  Augusta,  one-lialf,  at  Stony  Hill,  two-thirds 
of  the  whole  number  in  hospital.  They  arise  from  the  most  trifling  causes  ;  a  scratch,  or 
hint,  or  bruise  in  the  lower  extremities,  are  sufficient  to  produce  a  sore,  which  is  always 
difficult  to  heal,  and  sometimes  impossible.  Old  sores  often  break  out  anew,  and  nrove 
Equally  obstinate.” 

Dr.  Lind,  in  bis  valuable  work  on  scurvy,  bas  recorded  tbe  fact  that  tbe 
slightest  bruises  and  wounds  of  scorbutic  persons  may  degenerate  into 
offensive  bloody  and  fungous  ulcers,  which  are  prone  to  spread  with  great 
rapidity,  which  are  cured  with  the  greatest  difficulty.  The  distinguishing 
characteristics  of  scorbutic  ulcers,  as  given  by  Dr.  Lind,  are  as  follows  : 

“They  do  not  qfford  a  good  digestion,  but  a  thin  foetid  matter,  mixed  with  blood> 
which  at  length  has  the  appearance  of  coagulated  blood,  and  is  with  great  difficulty 
wiped  off  or  separated  from  the  parts  below.  The  flesh  underneath  these  sloughs  feels  to 
the  probe  soft  and  spongy.  No  irritating  applications  are  here  of  any  service  for  though 
such  sloughs  be  with  great  pains  taken  away,  they  are  found  again  at  next  dressing, 
when  the  same  bloody  appearance  always  presents  itself.  Their  edges  are  generally  of 
a  livid  color  and  puffed  up  with  excrescences  of  luxuriant  flesh  arising  under  the  skin. 
When  too  tight  a  compression  is  made,  in  order  to  keep  these  excrescences  from  arising ; 
they  are  apt  to  have  a  gangrenous  disposition  ;  aud  the  member  never  fails  to  become 
swelled,  painful  and  for  the  most  part  spotted.  As  the  disease  increases,  they  come  at 
length  to  shoot  out  a  soft  bloody  fungus,  which  the  sailors  express  by  the  name  of  Bul¬ 
lock’s  liver;  and  indeed  it  has  a  near  resemblance,  in  consistence  and  color,  to  that  sub¬ 
stance  when  boiled.  It  often  rises  in  a  night’s  time  to  a  monstrous  size,  and  although  de¬ 
stroyed  by  caustics,  or  the  knife  (in  which  last  case  a  plentiful  bleeding  generally  en¬ 
sues,  is  found  at  next  dressing  as  large  as  ever.  They  continue,  however,  in  this  condi¬ 
tion  a  considerable  time  without  tainting  the  bone.  The  slightest  bruises  and  wounds 
of  scorbutic  persons  degenerate  sometimes  into  such  ulcers.  Their  appearances  on  what¬ 
ever  part  of  the  body,  is  singular  and  uniform  ;  aud  they  are  easily  distinguished  from  all 
others,  by  being  so  remarkably  offensive,  bloody  and  fungous,  that  we  cannot  here  but 
take  notice  of  the  impropriety  of  refering  many  inveterate  and  obstinate  ulcers  on  the 
legs,  with  very  different  appearances,  to  scurvy;  which  are  generally  best  cured  by  giv¬ 
ing  mercurial  medicines  ;  whereas  that  medicine  in  a  truly  scorbutic  ulcer  is  the  most 
dangerous  and  pernicious  that  can  be  administered.” 

In  like  manner  Dr.  David  Macbnde  in  his  “  Methodical  Introduction  to 
the  Theory  and  Practice  of  Physic,”  London,  1772,  p.  618,  affirms  that : 

“  The  slightest  wounds  and  bruises  in  scorbutic  people  degenerate  into  foul  and  un¬ 
toward  ulcers.  And  the  appearance  of  these  ulcers  is  so  singular  and  uniform  that  they 
are  easily  distinguished  from  all  others.  Scorbutic  ulcers  afford  no  good  digestion,  but  a 
thin  and  foetid  ichor  mixed  with  blood,  which  at  length  has  the  appearance  of  coagulated 
gore  lying  caked  on  the  surface  of  the  sore,  and  is  with  great  difficulty  wiped  off  or  sep¬ 
arated  from  the  parts  below.  The  flesh  underneath  these  sloughs  feels  to  the  probe  soft 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


271 


and  spongy,  and  is  very  putrid.  No  detei’gents  nor  escliarotics  are  here  of  any  service  ; 
for  though  such  sloughs  he  with  great  pain  taken  away,  they  are  found  again  at  the  nevt 
dressing,  where  the  same  sanguiuous  putrid  appearance  always  presents  itself.  TheU' 
edges  are  generally  of  a  livid  color,  and  puffed  up  with  excrescences  of  putrid  flesh  aris¬ 
ing  from  below  the  skin.  As  the  violence  of  the  disease  increases,  the  ulcers  shoot  out 
a  soft  bloody  fungus,  which  often  rises  in  a  night’s  time  to  a  monstrous  size,  and  although 
destroyed  by  caustics,  actual  or  partial,  or  cut  away  with  the  knife,  is  found  at  next 
dressing  as  large  as  ever.  It  is  a  good  while,  however,  before  these  ulcers,  had  as  they 
are,  come  to  affect  the  bone  with  rottenness.” 

Sir  Gibert  Blaise,  in  his  “Observations  on  the  Diseases  of  Seamen,”  af¬ 
firms  that  there  is  no  complaint  more  hurtful  to  the  public  service,  by  sea 
and  land,  and  more  afflicting  to  the  individual  than  ulcers. 

“It  is  found,  says  Dr.  Blane,  in  the  work  just  referred  to  “  from  direful  and  multiplied 
experience,  that  not  only  those  who  are  affected  with  natural  symptoms  of  scurvy,  but 
those  who  are  exposed  to  the  causes  of  it,  and  whose  constitutions  are  in  such  a  train  as 
to  fall  into  it,  are  particularly  susceptible  of  ulcers  of  the  most  malignant  ki  d,  from  the 
smallest  injury  which  breaks  the  skin.  This  might  naturally  be  expected,  from  what  has 
been  said  from  the  great  debility  of  the  fibres,  and  deficiency  of  the  powers  of  renova¬ 
tion  and  nutrition  in  this  disease.  The  characteristic  symptoms  of  such  ulcers,  are,  a 
thin,  fetid  discharge,  commonly  mixed  with  blood,  which  sometimes  coagulates  on  the 
surface.  The  ulcerated  surface  is  soft  and  spongy,  generally  elevated  above  the  level  of 
the  surrounding  skin,  particularly  about  the  edges,  where  there  are  excrescences  of  luxu¬ 
riant  flesh,  which  in  the  more  advanced  state  of  the  ulcer,  shoots  into  a  soft  bloody  fungus, 
called  by  the  sailor’s  bullock’s  liver. — Third  Ed.,  London,  1799 — jj.  502. 

Dr.  Blane  records  a  number  of  important  observations  showing  the  ten¬ 
dency  to  foul  gangrenous  ulcers  amongst  seamen.  On  board  the  Ganges, 
of  seventy-four  guns  and  six  hundred  men,  during  the  year  1798,  the  tend¬ 
ency  to  the  complaint  was  such  that  the  smallest  sore,  whether  from  a  hurt 
or  a  pimple,  fell  into  the  state  of  an  ulcer.  Blistered  parts  were  also 
affected  in  the  same  manner.  Sores  which  seemed  to  be  in  a  healing  state 
would  suddenly  become  gangrenous.  A  black  speck  in  the  middle  was  the 
constant  precurser  of  this.  In  the  most  severe  cases  the  ulcers  began  with 
violent  inflammation,  which  suddenly  terminated  in  mortification  5  destroy¬ 
ing. in  a  short  time  the  fleshy  parts,  so  as  to  expose  the  bone,  which  soon 
became  carious. 

The  crew  of  the  Triumph,  of  seventy-four  guns  and  six  hundred  men? 
suffered  severely  from  malignant  ulcers  during  the  summer  and  autumn  of 
1798.  Not  only  wounds  and  blisters  fell  into  the  ulcerated  state,  but  a 
seartch  or  boils  and  the  orifice  of  the  arm  after  bleeding,  were  subject  to 
the  same  accident.  Sores  whicli  seemed  to  be  in  a  healing  state,  would 
suddenly  and  without  any  visible  cause,  spread  again,  and  become  foul  and 
bloody,  extremely  painful,  and  would  resist  every  means  of  cure. 

This  unfavorable  change  always  began,  as  in  the  Ganges,  with  a  black 
spot  in  the  middle  of  the  ulcer.  Ulcers  of  the  same  kind  prevailed  to  the 
most  dreadful  degree,  in  the  ships  serving  at  the  Cape  of  Good  Hope,  and 
in  the  Naval  Hospital  there,  in  the  years  1796  and  1797.  These  foul  ulcers 
produced  the  most  severe  and  protracted  sufferings, terminating  frequently 
in  the  loss  of  limbs  or  life,  or  both.  Nor  were  they  confined  to  the  lower 
extremities,  for  the  ossa-ilium,  the  scapula  and  cranium  would  sometimes 
become, carious.  It  became  frequently  necessary  to  amputate  at  the  hos¬ 
pital,  and  it  was  observed  that  if  the  patients  who  underwent  the  opera¬ 
tion,  remained  in  the  wards,  with  the  ulcers,  few  survived,  owing  to  the 
gangrenous  and  ulcerous  states  of  the  stumps;  but  when  they  were  carried 
into  a  separate  apartment,  the  large  majority  recovered. 

It  was  also  observed,  both  in  the  ships  and  at  the  hospitals,  where  this 
species  of  nicer  prevailed,  that  the  hands  of  those  who  dressed  them,  where 
the  skin  was  broken,  were  attacked  by  the  same  sort  of  ulcer. — Observa¬ 
tions  on  the  Diseases  of  Seamen ,  by  Gilbert  Blane,  M.  D. — pp.  50G-512. 


272 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


Dr.  Thomas  Trotter,  in  his  Medicina  Nautica ,  has,  in  like  manner,  re¬ 
corded  a  large  number  of  instances  where  malignant  gangrenous  ulcers 
have  arisen  spontaneously  in  various  ships,  and  attacked  with  violence,  not 
only  external  injuries,  but  in  a  number  of  cases,  where  neither  wound, 
puncture,  scab,  or  contusion  could  be  said  to  have  first  taken  place,  a  cir¬ 
cumscribed  red  spot  would  at  first  be  perceived,  scarcely  to  be  felt,  but  in 
a  few  hours  rising  to  a  pimple,  becoming  black  in  the  centre  and  inflamed 
around  the  edges,  till  it  increased  in  size,  swelled  and  assumed  every  char¬ 
acteristic  symptom  of  malignant  ulcer,  with  constant  fe\%r  and  subsequent 
ulceration,  slough  and  fetid  discharge.  This  malignant  ulcer  or  gangrenous 
ulcer  attacked  also  the  flesh  wounds  made  with  the  lancet  in  bleeding,  for 
different  inflammatory  diseases,  as  catarrhs  and  sore  throats.  Contused 
spots,  even  where  the  cuticle  was  not  broken,  were  not  exempted  from  the 
general  tendency  to  ulceration.  But  parts  that  had  been  scalded  or  burnt, 
above  all  accidents,  most  quickly  assumed  the  nature  of  this  horrid  sore, 
spread  and  inflamed  more  rapidly,  and  in  the  end  put  on  the  most  formid¬ 
able  appearance;  deeper  and  larger  sloughs  were  the  consequence,  and 
symptomatic  fever  violent  in  proportion.  Even  in  the  early  stage,  some¬ 
times  before  the  cuticle  had  burst  so  as  to  expose  the  naked  surface,  buboes 
appeared  in  the  groin  and  axilla,  not  to  be  touched  without  much  pain, 
and  always  attended  with  fever.  These,  however,  seldom  suppurated  ; 
but  where  they  did,  they  constantly  exhibited  the  complexion  of  the  parent- 
sore.  (Medicina  Nautica,  an  Essay  on  the  Diseases  of  Seamen,  by  Thomas 
Trotter,  M.  D.,  Sec.  Ed.,  1804,  vol.  2.  pp.  169 — 230;  vol.  3d,  pp.  497 — 504). 

Dr.  Trotter,  in  the  third  volume  states  that  in  the  summer  of  1799  the  malig¬ 
nant  ulcer  made  its  appearance  on  board  the  Temeraire,  with  all  the  char¬ 
acteristic  symptoms  and  violence  which  marked  it  in  other  ships.  Every 
wound,  abrasion  of  the  cuticle,  blistered  part,  scald  or  burn,  passed  rapidly 
through  the  various  stages  of  inflammation,  gangrene  and  sphacelus ;  in  a 
few  days  leaving  the  bones  almost  bare,  from  the  separation  of  immense 
sloughs. 

The  tendency  of  the  bones  to  caries  after  inflammation  in  this  disease, 
was  more  frequent  than  any  other  species  of  ulcer,  and  in  many  cases  ren¬ 
dered  the  cure  very  tedious  and  painful;  and  many  cases  sank  under  the 
long  confinement  necessary  to  the  separation  of  the  dead  bones. 

Dr.  Cleorge  H.  B.  Macloed,  in  his  u  Notes  on  the  Surgery  of  the  War  in 
the  Crimea,77  states  that 

“  The  French  suffered  most  dreadfully  from  hospital  gangrene  in  its  worst  form.  The 
system  they  persued,  of  removing  their  wounded  and  operated  cases  from  the  camp  to 
Constantinople  at  an  eai'ly  date,  the  pernicious  character  of  the  disease,  tended  to  render  it 
fatal  when  produced.  Many  of  their  cases  commenced  in  camp,  hut  the  majority  arose 
in  the  hospitals  on  the  Bosphorus,  where  the  disease  raged  rampant  In  the  hospitals  of 
France  it  also  prevailed,  and,  from  what  M.  Lallour,  Surgeon  to  the  Euphrate  trans¬ 
port,  tells  us  in  his  paper  on  the  subject,  it  must  have  committed  great  ravages  in  their 
ships,  from  one  of  which  he  says,  sixty  bodies  were  thrown  over  during  the  short  passage 
of  thirty-eight  hours  to  the  Bosphorus.  With  them  the  disease  was  the  true  gangrene,  and 
attacked  not  only  open  wounds  but  cicatrices,  and  almost  every  stump  in  the  hospitals.” 

By  the  official  reports  of  the  Medical  officers  of  both  the  English  and 
French  Armies,  during  the  Crimean  war,  it  was  conclusively  shown  that, 
notwithstanding  the  extraordinary  exertions  of  these  powerful  nations, 
holding  undisputed  sway  of  both  sea  and  land,  scurvy  and  a  scorbutic 
condition  of  the  blood,  increased  to  a  fearful  degree  the  mortality,  not  only 
of  gun-shot  wounds,  but  of  all  diseases,  and  especially  of  pneumonia, 
diarrhoea  and  dysentery. 

We  might  add  many  other  facts  from  various  authors  establishing  the 
spontaneous  origin  of  malignant  spreading  gangrenous  ulcers,  in  many 


273 


Spurious  Vaccination  :  Joseph  Jones ,  AT.  D. 

navies  and  armies,  as  the  result  of  scurvy  and  crowding  ;  but  the  facts  just 
recorded  are  sufficient  to  show  that  the  foul  scorbutic  ulcers,  and  hospital 
gangrene,  and  the  accidents  from  vaccination,  arising  at  Andersonville, 
were  by  no  means  new,  in  the  history  of  medicine,  and  that  the  causes 
which  induced  these  distressing  affections  have  been  active  in  all  wars  and 
sieges,  and  amongst  all  armies  and  navies. 

In  truth  these  men  at  Andersonville  were  in  the  condition  of  a  crew  at 
sea,  confined  upon  a  foul  ship,  upon  salt  meat  and  unvarying  food,  and 
without  fresh  vegetables.  Not  only  so,  but  these  unfortunate  prisoners 
were  like  men  forcibly  confined  and  crowded  upon  a  ship,  tossed  about  on 
a  stormy  ocean,  without  a  rudder,  without  a  compass,  without  a  guiding- 
star,  and  without  any  apparent  boundary  or  end  to  the  voyage ;  and  they 
reflected  in  their  steadily  increasing  miseries,  the  distressed  condition  and 
waning  fortunes  of  a  devasted  and  bleeding  country,  which  was  compelled, 
in  justice  to  her  own  unfortunate  sons,  to  hold  these  men  in  this  most  dis¬ 
tressing  captivity. 

The  Federal  prisoners  received  the  same  rations  in  kind,  quality  and 
amount,  issued  to  the  Confederate  soldiers  in  the  field.  These  rations  were, 
during  the  last  eighteen  months  insufficient,  and  without  that  variety  of 
fresh  meat  and  vegetables,  which  would  ward  off  scurvy  from  soldiers,  as 
well  as  prisoners. 

As  far  as  my  experience  extended,  no  body  of  troops  could  be  confined 
exclusively  to  the  Confederate  rations  of  1864  and  765  without  manifesting 
symptoms  of  the  scurvy. 

The  Confederate  ration  grew  worse  and  worse  as  the  war  progressed,  and 
as  portion  after  portion  of  the  most  fertile  regions  of  the  Confederate 
States  were  overrun  and  desolated  by  the  Federal  Armies.  In  the  straight¬ 
ened  condition  of  the  Confederate  States,  the  support  of  any  army  of  fifty 
thousand  prisoners,  forced  upon  their  hands  by  a  relentless  policy,  was  a 
great  and  distressing  burden,  which  consumed  their  scant  resources,  bur¬ 
dened  their  rotten  lines  of  railroad,  and  exhausted  the  over-taxed  ener¬ 
gies  of  the  entire  country,  crowded  with  refugees  from  their  desolated 
homes.  The  Confederate  authorities  charged  with  the  exchange  of  prison¬ 
ers,' used  every  effort  in  their  power  consistent  with  their  views  of  national 
honor  and  rectitude,  to  effect  an  exchange  of  all  prisoners  in  their  hands, 
and  to  establish  and  maintain  definite  rules  by  which  all  prisoners  of  war 
might  be  continuously  exchanged  as  soon  as  possible  after  capture. 

Whatever  the  feelings  of  resentment  on  the  part  of  the  Confederates 
may  have  been  against  those  who  were  invading  and  desolating  their 
native  land,  which  had  been  purchased  by  the  blood  of  their  ancestors 
from  the  Indians  and  English,  the  desire  for  the  speedy  exchange  and  re¬ 
turn  of  the  great  army  of  veterans,  held  captives  in  Northern  prisons,  was 
earnest  and  universal  5  and  this  desire  for  speedy  and  continuous  exchange 
on  the  part  of  the  government,  as  well  as  on  the  part  of  the  people,  sprang 
not  merely  from  motives  of  compassion  for  their  unfortunate  kindred  and 
fellow-soldiers,  but  also  from  the  dictates  of  that  policy,  which  would  ex¬ 
change  on  the  part  of  a  weak  and  struggling  people,  a  large  army  of  pris¬ 
oners  (consumers  and  nou-combatantsj,  requiring  an  army  for  their  safe¬ 
keeping),  for  an  army  of  tried  veterans. 

Apart  from  the  real  facts  of  the  case,  it  is  impossible  to  conceive  that 
any  government  in  the  distressed  aud  struggling  state  of  the  Confederate 
States,  could  deliberately  advocate  any  policy  which  would  deprive  it  of  a 
large  army  of  veterans,  and  compel  it  to  waste  its  scant  supplies,  already 
insufficient  for  the  support  ot  its  struggling  and  retreating  armies. 

Aud  the  result  has  shown  that  the  destruction  of  the  Confederate  Gov¬ 
ernment  was  accomplished  as  much  by  the  persistent  retention  in  captivity 


274 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


of  the  Confederate  soldiers,  as  by  the  emancipation  and  arming  of  the 
Southern  slaves,  and  the  employment  of  European  recruits. 

And  still  farther  to  show  that  these  accidents  attending  vaccination  at 
Andersonville  were  active  in  Northern  prisons,  we  quote  the  testimony  of  a 
medical  officer  who  occupied  during  the  war  a  distinguished  position  in  the 
Medical  Department  of  the  United  States  Army. 

Dr.  Frank  Hastings  Hamilton,  late  Lieutenant-Colonel,  Medical  Inspec¬ 
tor,  U.  S.  A.,  in  his  “  Treatise  on  Military  Surgery,”  records  the  follow¬ 
ing  facts,  which  havej  an  important  bearing  upon  the  subject  under 
consideration : 

“  In  still  further  confirmation  of  the  correctness  of  our  views,  we  will  mention  that  in 
many  of  the  regiments  stationed  in  Kentucky  and  Tennessee  during  the  summer  of  1863, 
all  slight  wounds,  such  as  scratches,  slight  burns,  etc.,  took  on  an  ulcerative  action,  and 
often  became  ugly  and  intractable  sores.  Vaccination  almost  constantly  produced  the 
same  results,  and  was  in  many  cases  followed  by  abscesses  in  the  axillary,  cervical  and 
other  glands. 

“  Upon  the  evacuation  of  Murfreesboro  by  the  Confederate  Army,  on  the  first  of  Janu¬ 
ary,  1863,  1673  sick  and  wounded  soldiers  were  left  on  our  hands  ;  of  these  250  were  sick, 
and  1423  were  wounded.  The  whole  number  were  placed  in  charge  of  Dr.  Avent,  the 
intelligent  Medical  Director  of  General  Bragg’s  army,  assisted  by  several  other  Confed¬ 
erate  surgeons,  and  were  allowed  to  remain  in  the  buildings  which  they  had  originally 
taken  as  hospitals,  and  which  were  the  best  the  place  afforded.  On  the  twentieth  of 
May,  1863,  nearly  five  months  after  the  battle  of  Stone’s  River  (Murfreesboro),  Dr.  Avent 
reported  to  us  that  640  of  these  men  had  died,  and  55  remained  in  the  hospital,  the  re¬ 
mainder  having  been  sent  off  for  exchange.  The  ratio  of  deaths,  continues  Dr.  Avent, 
allowing  the  same  percentage  for  the  55  now  on  hand,  is  about  38J  per  cent.  I  have  not 
separated  the  sick  in  this  calculation  from  the  wounded,  from  the  fact  that  the  hospitals 
were  common  to  both  ;  consequently  I  have  no  positive  data  on  which  to  make  an  esti¬ 
mate  of  the  relative  mortality.  I  am  satisfied,  however,  that  the  mortality  amongst  the 
sick  has  been  much  less  than  of  the  wounded.  An  estimate,  placing  the  percentage  of 
the  wounded  at  about  40,  I  think  would  not  be  far  wrong ;  which  loss,  you  will  discover, 
is  unprecedented  in  any  previous  battle  between  the  present  belligerents. 

“In  explanation  of  this  great  mortality  after  wounds,  Dr.  Avent  proceeds  to  offer  sev¬ 
eral  facts,  namely :  overcrowding  of  the  patients  in  the  hospital  buildings,  mental  de¬ 
pression,  the  fact  that  only  the  most  severely  wounded  were  left  behind  ;  but  he  gives 
especial  prominence  to  the  physical  condition  of  the  men,  in  consequence  of  a  prolonged 
absence  in  their  food  of  anti-scorbutic  articles,  both  before  and  since  their  capture.” 

We  have  here  a  far  heavier  mortality  amongst  these  Confederate  prison¬ 
ers  than  amongst  the  Andersonville  prisoners  ;  and  according  to  the  pub¬ 
lished  statements  of  the  United  States  Government,  the  majority  of  deaths 
during  the  war  was  largely  on  the  side  of  the  Confederate  soldiers  confined 
in  Northern  prisons.  And  after  careful  inquiries  amongst  returned  Con¬ 
federate  prisoners,  I  am  convinced  that  the  accidents  attending  vaccination 
were  quite  as  numerous  and  severe  in  Northern  prisons  as  in  Southern ; 
and  the  causes  of  death  amongst  prisoners  in  both  sections  were  not  ma¬ 
terially  different,  with  this  exception,  that  the  heat  of  the  Southern  States 
was  balanced  by  the  effects  of  severe  cold  upon  teeble  scorbutic  men  with 
insufficient  clothing. 

We  have  dwelt  thus  long  upon  this  subject,  because  we  have  considered 
its  discussion  of  paramount  interest  m  the  history  of  vaccination,  and  of 
the  medical  profession  in  America. 

In  many  cases,  occurring  in  the  Confederate  Army,  the  deleterious  effects 
of  vaccination  were  clearly  referable  to  the  condition  of  the  forces,  and  the 
constitution  of  the  blood  of  the  patients,  for  it  was  observed  in  a  number 
of  instances  that  the  same  lymph  from  a  healthy  infant,  inoculated  upon 
different  individuals,  produced  results  corresponding  to  the  state  of  the 
system  ;  in  those  who  were  well-fed  and  robust,  producing  no  ill  effects, 
whilst  in  the  soldiers  who  had  been  subjected  to  incessant  fatigue,  expos¬ 
ure  and  poor  diet,  the  gravest  results  followed. 


HOSPITAL  GANGRENE. 


PLATE  22. 


Fig.  91/  Arm  of  Federal  Pris¬ 
oner.  Hospital  Gangrene .  A  t- 
tacked,  small  abrasion  near  elbow. 
Amputation — Death.  Ander- 
sonville ,  Georgia ,  September  20, 

1864. 

From  Nature  by  «■ 

JOSEPH  JONES,  M.  D. 


MfcW  OftUANS  UTH- C*  10  union  ST 


275 


Spurious  Vaccination:  Joseph  Jones,  M.  D. 


As  this  subject  is  of  vast  importance  in  its  relations  to  the  theory  and 
practice  of  vaccination,  and  in  its  bearing  upon  the  fair  name  and  honor  of 
the  American  Medical  Profession,  we  have  substantiated  the  statements  by 
the  following  illustrations,  drawn  from  nature  : ' 

Plate  22,  Figure  91 — Arm  of  Federal  prisoner,  attacked  by  hospital  grangene,  in 
the  military  prison,  and  transferred  to  the  military  prison  hospital.  The  gangrene  at¬ 
tacked  a  small  abrasion  or  scratch  near  elbow  joint.  The  arm  was  amputated  about 
midway  between  the  elbow  and  shoulder  joints.  Hospital  gangrene  attacked  the  ampu¬ 
tation,  and  death  resulted  from  exhaustion  and  septic  poisoning. 

The  following  is  the  official  report  of  my  testimony,  with  reference  to  vaccination  of 
Federal  prisoners  at  Anderson  ville,  delivered  in  the  Military  Court  at  the  “ Trial  of  Henry 
Wirz 

“  By  counsel— Q.  Did  you  say  anything  about  vaccination  in  your  report? 

“A.  I  saw  some  cases  of  injury  from  vaccination.  I  do  not  recollect  exactly  what  I 
stated  in  my  report  on  that  subject,  but  I  can  tell  you  what  I  did  by  referring  to  it. 
There  were  a  number  of  instances,  I  think  some  dozens  of  instances,  that  I  was  informed 
of;  I  did  not  see  more  than  one  or  two  instances  myself ;  they  occurred  previous  to  my 
going  there.  The  case  which  I  examined  more  particularly  was  a  case  of  amputation  of 
the  arm  from  vaccination,  and  upon  carefully  examining  it,  I  was  led  to  believe  that  it 
was  in  consequence  of  the  condition  of  the  system  of  the  man,  rather  than  from  the  mat¬ 
ter  introduced,  from  the  fact  that  severe  injuries  were  frequently  attended  with  gan¬ 
grene  in  that  foul  atmosphere. 

“From  the  crowded  condition,  filthy  habits,  bad  diet,  and  dejected,  depressed  condi¬ 
tion  of  the  prisoners,  their  systems  had  become  so  disordered  that  the  smallest  abrasion 
of  the  skin,  from  the  rubbing  of  a  shoe,  or  from  the  prick  of  a  splinter,  or  from  scratch¬ 
ing,  or  a  musquito  bite,  in  some  cases,  took  on  rapid  and  frightful  ulceration  and  gan¬ 
grene.”  ( Fortieth  Congress,  Second  Session ,  House  of  Representatives.  Ex.  Doc.  No.  23, 
Trial  of  Henry  Wirz.  Letter  from  the  Secretary  of  War  ad  interim,  in  answer  to  the 
resolution  of  the  House,  April,  16,  1866,  transmitting  a  trial  of  Henry  Wirz,  December  7, 
1867.  Referred  to  the  Committee  on  the  Judiciary  and  ordered  to  be  printed.  P.  642, 
p.  625.) 

The  following  is  the  record  which  I  made  on  the  Confederate  Military  Prison  Hospital 
at  Andersonville: 

The  dra  wing,  Plate  22,  Figure  91,  was  made  by  myself  from  the  arm  of  a  Federal  pris¬ 
oner,  who  had  scratched  and  abraded  the  skin  around  the  bite  of  some  insect,  most  prob¬ 
ably  that  of  a  mosquito,  inflicted  in  the  stockade. 

The  abrasion  did  not  heal,  but  gradually  assumed  a  dark,  unhealthy  hue  ;  and  the  irri¬ 
tation  commenced  to  spread.  In  two  weeks  it  had  reached  the  size  of  a  silver  half-dol¬ 
lar.  This  patient  was  then  transferred  to  the  Confederate  States  Military  Prison  Hos¬ 
pital,  and  in  the  course  of  six  days  it  reached  the  size  and  presented  the  appearance 
represented  in  the  drawing  (Plate  22,  Figure  91).  When  I  examined  this  patient  the  con¬ 
stitutional  symptoms  were  well  marked— hot,  dry  skin;  small,  rapid,  feeble  pulse; 
leaden,  sallow,  unhealthy  hue  of  complexion  ;  dejected,  distressed  countenance;  coated 
and  tremulous  tongue.  The  stench  emitted  from  this  gangrenous  mass  presented  a 
ragged,  pulpy,  putrescent  mass,  without  pus,  and  with  ragged,  everted  edges,  elevated 
above  the  surrounding  tissues.  It  was  also  surrounded  by  a  livid  blue  and  deep  purple 
border  on  the  skin.  The  deep  blue  and  purple  areola  is  a  sure  index  of  the  spread  of 
hospital  gangrene.  The  patient  was  most  urgent  in  his  entreaties  for  the  removal  of  the 
arm,  and  it  was  decided,  upon  consultation  with  the  attendant  medical  officers,  that  his 
condition  could  not  be  rendered  worse  by  an  amputation,  which  would. substitute  a 
smaller  flesh  wound  for  this  most  extensive  and  foul  ulcer,  invading  the  joint  and  excit¬ 
ing  intense  pain. 

Notwithstanding  the  probability  that  in  the  condition  ,of  the  system  of  the  patient,  in 
this  foul  atmosphere,  the  gangrene  would  return  again  in  the  stump,  it  was,  neverthe¬ 
less,  considered  proper  to  amputate,  on  account  of  the  reasons  just  given. 

Numerous  amputations  had  been  performed  in  the  Confederate  States  Military  Prison 
tor  gangrene  supervening  upon  slight  injuries,  and  attacking  scorbutic  ulcers.  I  en¬ 
deavored  to  collect  all  the  cases  with  the  results,  but  the  records  were  imperfect  and  in¬ 
complete.  Upon  the  incomplete  reports,  266  cases  of  hospital  gangrene  were  recorded  ; 
out  of  sixty-six  amputations  in  consequence  of  the  disease  with  twenty-five  deaths;  one 
hundred  and  two  cases  are  given  as  supervening  upon  gun-shot  wounds,  and  the  remain¬ 
der  were  reported  as  gangrenous  ulcers  arising  from  the  scorbutic  and  deranged  condi¬ 
tion  of  the  system. 

Twelve  cases  of  gangrenous  ulcers  were  recorded  as  following  vaccination. 

These  figures  are  far  below  the  truth. 

Many  cases  of  gangrenous  ulceration  which  were  in  the  hospitals,  were  originally  en¬ 
tered  upon  the  hospital  registers  under  the  head  of  scurvy,  diarrhoea,  dysentery,  or  some 
other  disease.  *’ 


276 


Spurious  Vaccination:  Joseph  Jones ,  M.  D. 


Hospital  gangrene  returned  almost  invariably  after  amputation  in  these  scorbutic  and 
enfeebled  patients,  and  in  this  infected  atmosphere;  and  in  some  cases  the  disease  reap¬ 
peared  in  the  stump  within  thirty-six  hours  after  the  operation. 

I  extract  the  following  from  a  report  on  hospital  grangrene  at  Andersonville  Prisou, 
drawn  up  by  Assistant  Surgeon  A.  Thornburgh,  of  the  Confederate  Army,  in  response  to 
my  official  request : 

Early  in  the  spring  (1864)  small-pox  made  its  appearance  in  the  prison,  and  as  a  pro¬ 
phylactic  measure,  we  were  ordered  to  vaccinate  all  who  could  not  show  the  proper  vac¬ 
cine  scar;  consequently  we  went  to  work,  and  in  a  week  or  ten  days  two  or  three  thou¬ 
sand  were  vaccinated.  Out  of  this  number,  nearly  every  prisoner  who  happened  to  be 
affected  with  scurvy  was  attacked  with  ulceration  of  the  pustule.  These  small  ulcers 
soon  began  to  slough,  and  extend  over  a  large  extent  of  surface;  when  the  superficial 
sloughs  were  separated,  the  parts  beneath  were  found  to  be  in  an  unhealthy,  sloughing 
condition;  finally  these  ulcers  would  become  phagedenic,  and  destroy  every  structure 
in  their  track  for  a  considerable  extent.  In  this  condition  gangrene  would  set  in,  and  if 
the  disease  was  not  speedily  arrested  by  powerful  escharotics,  emollient  poultices,  and 
the  proper  vegetable  diet,  amputation  became  necessary,  or  the  poor  sufferer  sank  under 
this  irritation.  Diarrhoea  and  dysentery  frequently  supervened,  and  speedily  destroyed 
the  patient.”* 

That  exposure,  hardship,  improper  and  scant  and  salt  food  had  pro- 
puced  a  similar  condition  in  the  Confederate  troops  is  conclusively  shown, 
bv  Plate  23,  Figure  92.  Leg  of  J.  S.  Cole,  private  Third  Regiment,  Georgia, 
Reserves;  guarding  Federal  prisoners  at  Andersonville,  Georgia,  Septem¬ 
ber  22,  1864,  while  guarding  the  stockade,  hospital  grangrene  attacked 
some  abrasions  of  the  skin  on  the  right  foot  and  leg. 

The  following  is  the  detailed  statement  of  this  case  : 

“  Case  54. — General  Hospital  for  Confederate  soldiers,  Andersonville,  Goorgia,  Septem" 
her  22,  1864.  Thomas  Cole,  priiate  3d  Regiment,  Georgia  Reserves,  Company  H.  Age- 
sixteen  years  ;  height,  five  feet  nine  inches  ;  weight  in  health,  150  pounds.  Arrived  at 
Andersonville  on  the  twentieth  of  July.  Was  engaged  in  guarding  prisoners  at  the 
stockade.  Performed  guard  duty  every  third  day  ;  two  hours  ou  and  four  hours  oft',  during 
the  twenty-four  hours.  Before  leaving  home,  received  a  slight  scratch  on  the  side  of  the 
left  foot,  a  little  below  the  ankle.  This  boy  did  not  usually  wear  shoes  at  home,  and  on 
the  way  to  Andersonville  the  shoes  bruised  and  enlarged  the  small  injury.  This  small 
abrasian  did  not  heal  after  the  commencement  of  his  duties  as  a  soldier  at  Andersonville. 

It  did  not,  however,  give  him  any  special  trouble,  or  appear  inflamed,  until  about  the 
first  of  September,  forty-two  days  after  his  arrival  at  this  post. 

Up  to  this  time  this  young  recruit  had  never  been  inside  the  stockade,  and  had  never 
stood  guard  around  or  within  the  hospital.  On  the  fourth  of  September,  the  patient 
was  compelled  to  quit  duty,  and  on  the  twelfth  instant  he  was  transferred  to  the  Con¬ 
federate  General  Hospital. 

At  the  time  of  his  entrance  into  the  hospital,  the  gangrenous  spot  was  not  larger 
than  a  silver  half  dollar,  and  presented  an  inflamed  areola  on  the  sound  skin,  elevated, 
everted  edges,  and  elevated  pulpy,  ragged  greenish  central  mass. 

Up  to  the  date  of  making  the  drawing,  the  gangrene  has  spread  rapidly,  presenting 
the  appearance  represented  in  Plate  23,  Figure  92. 

Hemorrhage  was  constantly  taking  place  from  the  numerous  small  eroded  vessels,  and 
hence  the  red  and  mattiered  appearance  of  certain  portions  of  the  gangrenous  mass. 
Several  smaller  gangrenous  spots  were  visible  upon  the  leg  and  are  represented  in  the 
figure.  These  are  said  1o  have  arisen  spontaneously;  that  is  without  any  preceding 
abrasian  or  injury.  The  black  mass  in  the  centre  of  the  large  ulcer  upon  the  ankle  joint, 
appeared  to  be  the  surface  of  the  nqcrosed  bone. 

The  constitutional  symptoms  were  well  marked  in  this  case.  At  night  when  I  exam¬ 
ined  the  patient  he  had  hot  fever,  with  rapid  pulse,  pale  aneamic,  sallow,  unhealthy 
complexion.  This  morning  has  less  heat  of  surface,  and  the  pulse  is  less  frequent,  but 
still  there  is  febrile  excitement,  and  he  is  very  nervous  and  weak  ;  cries  like  a  child 
when  his  wound  is  touched,  even  in  the  gentlest  manner.  Bowels  loose;  had  a  large, 
loose,  yellow,  very  qffensive  evacuation  whilst  I  was  engaged  in  executing  the  sketch? 

Plate  No.  24,  Figure  93:  Hand  of  W.  J.  Black,  Confederate  soldier,  poisoned  in  dress¬ 
ing,  hospital  gangrene,  October  3,  1864. 

The  following  record  of  this  case  was  made  by  myself  during  the  investigations  on 
hospital  gangrene,  instituted  in  the  Empire  Hospital,  Vineville,  Georgia: 


*Surgical  Memoirs  of  the  United  States  Sanitary  Commission .  Investigations  upon  Hospital  Gangrene 
as  it  prevailed  in  the  Confederate  Armies,  1861-1865,  by  Joseph  Jones,  M.  B.,  formerly  Surgeon  in  the  Pro¬ 
visional  Army  of  the  Confederate  States.  New  York,  1811;  p.  528. 


HOSPITAL  GANGRENE. 


PLATE  23. 


Fig.  92/  Ugof  T.  S.  Cole, 
Private  3d Regiment  Georgia 
Reserves /  guarding  Federal 
Prisoners  at  Andersonville , 
Georgia,  September 22,  1864. 
While  guarding  the  Stockade, 
Hospital  Gangrene  attacked 
some  abrasions  of  the  skin  on 
the  right  foot  and  leg. 

From  Nature  by 

JOSEPH  JONES ,  Af.  D. 


t>,i NEW  ORLEANS  IfTH  CV  10  UNION  ST 


Spurious  Vaccination:  Joseph  Jones ,  M.  D. 


277 


Case  7,  Empire  Hospital,  Yineville,  Georgia.  W.  J.  Black,  Company  “  G,”  Lee’s  In¬ 
valid  Battalion  ;  aged  forty-six  years  Native  of  Troup  county,  Georgia.  Farmer  by 
occupation.  Height,  5  feet  9  inches;  weight,  in  health,  160  pounds;  black  hair  and 
eyes;  florid  complextion.  Has  been  in  Confederate  service  three  years  and  three ‘months. 
Served  two  years  with  “Stonewall”  Jackson.  Was  wounded  about  one  year  ago  in 
Maryland  ;  lost  the  first  joint  of  the  second  finger,  and  has  not  been  in  field  service  since. 
Has  been  acting  as  a  nurse  in  this  hospital  for  the  past  two  months,  since  the  conversion 
of  this  hospital  into  a  gangrene  hospital. 

During  this  time  has  been  inoculated  with  hospital  gangrene  twice.  The  first  attack 
was  caused  by  a  prick  of  a  pin  on  the  side  of  the  hand,  received  in  dressing  a  gangrenous 
wound.  The  prick  of  the  pin  became  painful  almost  immediately,  and  in  the  course  of 
two  days  the  injury  commenced  to  inflame,  and  the  surface  around  assumed  a  purplish 
and  bluish  color.  The  disease  spread  from  the  centre  of  infection,  and  the  slough  pre¬ 
sented  a  grayish  and  greenish  color.  The  inflamed  and  gangrenous  parts  were  freely 
cauterized  with  strong  nitric  acid.  By  this  means  the  gangrene  was  arrested  before  the 
ulcer  had  exceeded  one-quarter  of  an  inch  in  diameter.  This  occurred  in  the  beginning 
of  September,  about  one'month  before  the  drawing  was  made.  The  constitution  did  not 
appear  to  suffer,  the  wound  healed  readily,  and  the  patient  resumed  his  labors  as  a  nurs- 
to  the  gangrene  patients. 

Had  not  been  engaged  in  dressing  the  gangrenous  wounds  more  than  two  or  three  days 
before  a  small  blister  appeared  on  the  third  finger  of  his  right  hand,  which  gave  much 
pain,  and  in  the  language  of  the  patient  “throbbed  as  if  a  bone  was  breaking  loose.” 
The  blistered  surface  assumed  a  gray  and  greenish  color,  and  was  surrounded  with  a 
purplish  and  blue  halo  in  the  skin.  The  gangrene  commenced  to  spread  rapidly.  Con¬ 
centrated  nitric  acid  was  immediately  applied  three  times  a  day,  but  it  did  not  arrest  the 
gangrene.  * 

It  appears  that  in  the  first  inoculation,  the  system  was  not  specially  involved,  and  the 
local  treatment  arrested  the  disease.  But  the  continued  residence  in  this  infected  at¬ 
mosphere,  and  the  constant  attention  upon  the  gangrenous  wounds,  gradually 
poisoned  the  system  of  this  faithful  nurse  to  such  an  extent,  that  in  the  second  attack  the 
local  treatment  did  not  arrest  the  disease. 

On  the  third  of  October,  1864,  just  twelve  days  after  the  commencement  of  this  second 
attack  of  hospital  gangrene,  1  executed  the  drawing  (Plate  24,  Figure  93). 

The  gangrene  is  progressing  along  the  upper  border,  under  the  bluish  discolored  shin 
of  the  third  finger  of  the  right  hand.  The  color  of  the  skin  in  this  portion  of  the  wound, 
where  the  gangrene  is  progressing  most  rapidly,  was  of  a  most  remarkable  deep  blue. 
The  lower  portion  of  the  ulcer  appears  to  be  improving  somewhat,  and  now  discharges 
a  little  pus. 

The  constitutional  disturbances,  notwithstanding  the  comparatively  small  surface  in¬ 
volved,  are  well  marked,  pulse  accelerated  and  feebler  than  in  health.  Face  flushed. 
During  the  execution  of  the  sketch  of  his  right  hand,  suffered  much  pain  from  the  con¬ 
fined  position  of  the  hand  ;  was  very  restless  and  uervous,  and  was  much  nauseated,  and 
attempted  several  times  to  vomit.  Hands  tremble  from  the  nervous  exhaustion.  No  ap¬ 
petite.  Tongue  of  a  purplish,  bluish,  leaden  color.  Has  fever  in  the  morning,  which 
declines  toward  the  evening.  Feels  weak,  nervous,  feverish  and  depressed.  Urine 
brownish  red  and  scant. 

On  the  seventh  of  October,  gangrene  still  spreading.  Patient  sent  out  of  Hospital 
into  the  country. 

The  history  of  vaccination  in  the  Army  of  Virginia,  under  General  Lee, 
was  of  great  interest,  in  the  light  which  it  threw  upon  these  questions,  and 
it  is  with  deep  regret  that  we  learn  that  all  the  most  valuable  field  reports 
were  destroyed. 

The  following  letter  from  Dr.  L.  Guild,  formerly  Medical  Director  of  the 
Army  of  Northern  Virginia  (General  Lee’s  Army),  was  received  in  reply  to 
my  request,  for  the  experience  upon  this  subject,  of  this  surgeon,  who  had 
held  one  of  the  most  responsible  and  distinguished  positions  in  the  Medical 
Department  of  the  Confederate  Army. 

Mobile,  Ala'.,  Decembe  12,  1866. 

Professor  Joseph  Jones  : 

Dear  Sir — Your  letter  of  the  fifth  inst.,  has  been  received.  It  would  afford  me  great 
pleasure  to  contribute  to  your  contemplated  monograph  on  “Spurious  Vaccination,” 
but  in  the  retreat  of  tne  Army  of  Northern  Virginia  from  Petersburg  lo  Appomattox 
Court-House,  all  of  the  retained  papers,  professional  notes,  reports,  etc.,  of  my  office 
were  either  destroyed  by  the  enemy  or  burned,  with  other  baggage,  byour  own  people 
for  the  purpose  of  lightening  our  trains,  and  facilitating  the  movement  of  our  letreating 


278 


Spurious  Vaccination:  Joseph  Jones,  M.  D. 


columns.  When  the  boxes  were  burned  their  contents  were,  of  course,  unknown  to  those 
entrusted  with  the  execution  of  the  order.  Ou  accouut  of  this  unfortunate  occurrence, 
I  have  nothing  with  which  to  refresh  my  memory  accurately,  in  a  single  case,  out  of  a 
vast  number  that  came  under  my  observation. 

The  subject  of  transmission  of  syphilis  through  the  vaccine  virus  is  a  most  interesting 
and  important  one  to  the  profession — admitting  great  diversity  of  opinion,  and,  as>ou 
truthfully  remark,  “one  well-reported  case  is  worth  volumes  of  mere  opinions  and  asser¬ 
tions  ” 

I  know  of  no  one  who  could  report  such  a  case,  but  much  useful  information  on  the 
subject  can  be  furnished  by  Dr.  R.  J.  Breckinrigde — now  of  Houston,  Texas — formerly  of 
Louisville,  Ky.  He  was  one  of  the  Me.1',;!,;  |  spectors  of  the  Army  of  Northern  Virginia, 
and  it  was  his  duty,  ou  several  occasio  ,o  collect  all  interesting  facts  and  opinions  on 
the  subject,  such  as  the  nature  and  chai..  ‘ter  of  the  ulcers  following  vaccination,  anterior 
history  of  patients,  etfects  of  treatment  constitutional  and  local;  etc.,  etc. 

I  regret  my  inability  to  furnish  something  worthy  of  your  consideration 

Respectfully,  yours,  etc.,  L.  GUILD. 

The  testimony  of  Dr.  S.  E.  Habersham,  upon  this  cause  of  the  abnor¬ 
mal  phenomena  accompanying  and  following  vaccination,  is  clear  and  im¬ 
portant. 

The  following  report  was  placed  in  my  hands  by  its  author,  and  was  ac¬ 
companied  with  the  following  answer  to  my  request  and  inquiries  : 

Summerville,  April  28,  1866. 

Dr.  Joseph  Jones: 

Dear  Sir — The  accompanying  reporl  of  an  anomalous  disease  or  the  result  of  vac¬ 
cination,  was  written  shortly  after  its  first  appearance  in  the  Army  of  Northern 
Virginia,  and  after  a  careful  study  of  the  cases  especially  assigned  to  the  hospital 
under  my  charge  for  “treatment  and  report.”  At  the  time  there  was  much  discus¬ 
sion  among  the  medical  staff,  both  in  field  and  hospital,  as  to  the  aetiology  and  pathology 
of  the  manifestation  which  by  some,  and,  indeed,  most  of  the  observers,  was  attributed 
to  impure  virus,  and  especially  syphilitic  Inoculation.  This  latter  opinion  was  ingeni¬ 
ously  advocated  by  Surgeon  Breckinridge,  and  no  doubt  many  cases  may  have  resulted 
from  such  an  accident.  In  none  of  the  cases,  however,  assigued  to  my  division  of  Chim¬ 
borazo  Hospital,  could  I  discover  a  sufficient  number  of  symptoms  to  lead  me  to  suppose 
that  such  miglit  have  beeu  the  cause,  either  in  its  prodoma  or  development,  hence  I  could 
not  attribute  the  cause  of  the  eruption  to  any  other  than  that  assigned  in  the  report. 
This  view  as  to  its  aetiology  was  subsequently  very  ably  maintained  by  Surgeon  Frank 
A.  Ramsey,  in  a  report  referred  to  me  by  Surgeon-General  Moore,  and  which  was  pre¬ 
served  among  my  papers,  but  lost  at  the  time  of  the  evacuation  of  Richmond,  together 
with  the  history  of  all  the  cases,  and  diagrams  intended  to  illustrate  the  above  report. 
Iu  consequence  of  the  loss  of  these  papers,  this  report  is  not  as  perfect  as  it  should  be; 
but  I  hope  the  general  description  and  history  of  the  disease  is  sufficiently  clear  and  com¬ 
prehensive  to  embrace  everything  of  practical  importance  concerning  this  horribly  dis¬ 
gusting  and  filthy  accident,  or  result  of  vaccination,  as  seen  in  our  army. 

Since  the  termination  of  the  war,  I  have  had  several  opportunities  of  conversing  with 
a  few  intelligent  surgeons  of  the  Federal  Army,  and  ascertained  from  them  that  such  a 
disease  had  appeared  among  their  soldiers  in  regions  of  country  where  the  scorbutic  dia¬ 
thesis  manifested  itself  among  the  troops,  and  to  which  the  disease  was  generally  attrib¬ 
uted  by  them,  though  there  were  also  surgeons  of  that  army  who  attributed  it  to  syphil¬ 
itic  inoculation.  I  find  the  same  view  as  advanced  in  the  accompanying  report  held  by 
most  of  the  Surgeons  of  the  Federal  Army,  as  stated  in  Circular  No.  6,  Surgeon-General’s 
Office,  United  States  Array,  November  1,  1865. 

If  you  think  my  report  of  sufficient  importance  to  appear  upon  the  pages  of  your 
journal,  or  if  it  can  in  any  way  advance  the  cause  of  medical  knowledge,  you  are  at  per¬ 
fect  liberty  to  make  use  of  it  for  that  purpose. 

With  much  respect,  I  remain,  very  truly,  your  obedient  servant, 

S.  E.  HABERSHAM. 

Report  on  Spurious  Vaccination  in  the  Confederate  Army.  By  S.  E.  Habersham,  M.  D., 
Surgeon  in  the  Provisional  Army  of  the  Confederate  States: 

Chimborazo  Hospital,  Division  No.  2,  November,  1863. 

To  Surgeon  W.  A.  Carrington,  Medical  Director : 

Sir — I  have  the  honor  to  inform  you  that,  in  accordance  with  your  order  of  the  twenty- 
ninth  June,  1863, 1  have  received  all  the  patients  sent  into  this  Division,  with  a  “peculiar 
eruptive  disease,”  supposed  to  be  the  consequence  of  vaccination,  and  herewith  forward 
you  the  results  of  my  investigation  in  this  anomalous  affection. 

In  compliance  with  an  order  issued  from  the  Surgeon  General’s  office,  in  the  month  of 
November,  1862,  general  vaccination  was  practiced  upon  all  soldiers  as  soon  as  they  were 
admitted  in  this  Division,  and  in  order  to  insure  the  full  protective  influence  of  vaccina- 


ft 


HOSPITAL  GANGRENE 


PLATE  24 


Fig.  93/  Hand  of  Confederate  Soldier ,  pois¬ 
oned  by  prick  of  pin — in  dressing  Hospital  Gan¬ 
grene.  W.  J.  Black,  C.  S.  A.,  October  3 d, 

1864. 

From  Nature  by 

JOSEPH  JONES,  M.  D. 


T.C.NEW  ORLEANS  MYH.C?IO  UNION  ST. 


I 


Spurious  Vaccination  :  Joseph  Jones ,  M.  T). 


279 


tion  (not  anticipating  any  evil  consequences  therefrom),  the  order  was  strictly  obeyed, 
and  all  the  patients,  even  those  having  recent  scars  upon  them,  were  re-vaccinated.  A 
few  days  after  the  insertion  of  the  virus,  and,  in  many  cases,  within  twenty-four  hours, 
the  seat  of  puncture  became  very  much  inflamed,  with  a  deep  inflammatory  blush  around 
it,  which  gradually  implicated,  in  the  severe  cases,  nearly  the  whole  of  the  affected 
limb.  A  pustule  rapidly  formed,  instead  of  a  vesicle,  which  very  soon  discharged  an  ich¬ 
orous  fluid.  This  fluid  was,  in  the  course  of  forty-eight  hours,  converted  into  a  dark, 
mahogany-colored  irregularly- shaped  scab,  prominent,  and  firmly  attached  at  its  base. 
A  rtark-red  areola  of  several  lines  in  diameter,  measuring  from  the  edge  of  the  scab,  was 
then  developed,  which,  in  turn,  seemed  to  exude  an  ichorous  serum.  This  was  soon  con¬ 
verted  into  a  scab  surrounding  in  juxtaposition  the  first,  and  presented  the  appearance 
of  a  single  scab.  This  process  continued  for  several  days,  and  there  was  often  formed  a 
scab,  one  inch  or  two  and  a-halfin  diameter.  “Pari  passu”  with  the  increase  of  this 
scab,  the  erysipelatous  blush*  on  the  limb  diminished,  and  when  the  blush  had  disap¬ 
peared,  this  scab  ceased  to  enlarge.  As  this  inflammatory  process  subsided,  the  dis¬ 
charge  lost  its  serous  character,  and  seemed  to  be  converted  into  pus,  which  exuded  from 
under  the  scab,  loosening  its  firm  attachment  at  its  base,  and  thus  rendering  it  liable  to 
be  removed  prematurely  by  the  patient  in  his  sleep,  or  even  by  the  friction  of  his  cloth 
ing.  When  this  occurred,  a  foul  bleeding,  irregularly-shaped  phagadeuic  ulcer  was  re¬ 
vealed,  with  everted  edges,  and  presenting  the  appearance  of  a  syphilitic  phagedenic- 
ulcer,  involving  the  subcutaneous  areola  tissue,  exposing,  in  many  cases,  the  muscuiar 
tissue  below.  The  process  of  destruction  of  parts  did  not  end  here,  for  the  ulcer  contin¬ 
ued  to  increase,  and  from  the  loosened  edges  an  ichorous  discharge  continued  to  pour 
out  from  under  the  skin  which  seemed  to  destroy  the  edges  of  the  ulcer,  thus  increasing 
its  dimensions.  Wherever  the  ichorous  pus  from  this  ulcer  touched  the  sound  skin,  an¬ 
other  pustule  of  a  similar  character  was  formed,  in  some  cases  reaching  the  size  of  the 
primary  sore  This,  however,  was  seldom  the  case,  but  a  smaller  ulcer  generally  re¬ 
sulted,  which  often  healed  and  cicatrized  before  the  first. 

The  axillary  glands,  when  the  arm  was  affected,  and  the  inguinal  glands,  when  the 
leg  was  the  seat  of  the  disease,  sometimes  became  inflamed  and  discharged  pus,  pre¬ 
senting  the  microscopic  character  of  healthy  pus.  This  enlargement  of  the  glands, 
however,  did  not  occur  in  a  sufficient  number  of  cases  to  make  it  a  natural  sequence  of 
the  disease.  Attending  the  early  stages  of  the  formation  of  the  ulcer,  before  pus  was 
discharged,  there  was  always  more  or  less  pyrexia,  with  furred  tongue  and  loss  of  appe¬ 
tite  ;  these  symptoms  disappearing  as  soon  as  ulceration  was  established.  In  these 
highly  aggravated  cases,  successive  crops  of  pustules  made  their  appearance  on  the  af¬ 
fected  limb,  often  developing  themselves  also  upon  the  lower  limbs  of  the  affected  side, 
but  seldom  crossing  the  mesian  line,  and  never  developing  themselves  ubon  the  trunk  or 
head.' 

The  less  malignant  form  of  the  disease  resembled  the  first  in  character,  but  not  in  de¬ 
gree.  For  a  few  days  after  the  insertion  of  the  virus,  merely  a  small  inflamed  spot  was 
discerned,  which  seemed  to  be  more  the  resultof  the  injuryr  done  to  the  skin,  by  the  prick 
of  the  lancet,  than  any  inflammatory  action  resulting  from  a  specific  cause.  About  the  fifth 
or  sixth  day  a  minute  pustule  was  discerned  upon  a  scarcely  larger  inflamed  base,  This 
pustule  and  areola  gradually  increased,  but  the  diameter  of  the  areola  was  not  as  great, 
and  there  was  no  deep  inflammatory  blush  upon  the  arm,  merely  a  diffused  redness  of 
several  inches  in  diameter.  The  same  process,  however,  took  place — an  exudation  of 
serum  from  the  areola — which,  in  turn,  became  a  crust,  and  which  gradually  increased  in 
size,  but  it  never  reached  the  diameter  of  the  more  malignant  type  ;  and  when  it  was  de¬ 
tached  by  the  process  of  ulceration,  which  occurred  at  an  early  period,  the  revealed 
ulcer  was  neither  as  deep  nor  as  malignant  in  its  appearance.  The  edges  were  not  everted, 
and  there  was  no  discharge  of  pus  from  under  the  edges  of  the  ulcer;  it  only  presented 
the  appearance  of  an  ordinary  ulcer,  showing  no  tendency  to  increase,  and  but  little  to 
heal.  Pyrexia  very  seldom  attended  this  form,  nor  was  the  appetite  impaired. 

The  third  and  mildest  form  of  the  disease  made  its  appearance  as  a  small  pimple,  in 
from  two  to  ten  days  after  the  introduction  of  the  virus,  and  which  gradually  formed  a 
pustule  ;  a  dark  brown  scab  succeeded  in  from  three  to  four  days,  which  remained  attached 
sometimes  as  long  as  two  weeks,  and  when  it  become  detached,  a  livid  or  brown  spot  was 
revealed,  the  size  of  which  was  equal  to  the  scab.  This  scar,  however,  was  very  sensi¬ 
tive  to  the  touch,  and  liable  to  bleed  from  the  least  friction  of  clothing,  and  when  this 
occurred,  it  would  exude  serum  or  blood,  and  another  scab  would  surely  form.  If  the 
system  became  suddenly  depressed  from  any  cause,  it  would  almost  always  assume  the 
ulcerative  process,  and  become  a  sloughing  ulcer,  which  only  healed  with  the  general 
improvement  of  the  system. 

As  thus  described,  this  disease  has  prevailed  in  the  Army  of  Virginia,  both  in  field  and 
hospital.  The  surgeons  of  the  Army  of  the  Southwest  report  its  prevalence  there.  It 
was  developed,  in  the  early  part  of  the  year,  in  a  cavalry  regiment  in  the  mountains  of 
Virginia,  the  Colonel  commanding  suttermg  severely  from  the  disease.  In  every  case  its 
origin  has  been  traced  to  the  introduction  of  vaccine  virus  into  the  system.  How  far  an 


280 


Spurious  Vaccination:  Joseph  Jones ,  M.  D. 


epidemic  cause  may  have  exerted  its  influence  in  its  early  development  it  is  impossible 
even  to  surmise  ;  we  know,  however,  that  it  originated  in  Virginia,  at  a  time  when  onr 
Army  was  upon  very  short  rations,  and  that  many  of  the  soldiers  sent  from  the  field  at 
that  time  presented  a  decidedly  scorbutic  appearance.  Many  had  been  reduced  and  were 
broken  down  by  exposure  to  the  inclemency  of  a  cold  winter,  and  the  depressing  influ¬ 
ences  of  low  diet,  want  of  clothing,  and  many  other  prolific  causes  of  disease,  calculated 
to  deprive  the  blood  of  its  healthy  constituents,  particularly  of  its  fatty  matter.  Hence 
this  may  have  produced  a  predisposition.  In  verification  of  this  fact,  I  will  state,  that 
when  it  was  found  how  frequently  the  disease  in  consideration  supervened  upon  vaccina¬ 
tion  in  this  hospital  in  broken-down  and  depraved  constitutions,  it  was  deemed  prudent 
to  postpone  the  introduction  of  the  virus  until  the  patient  was  restored  to  a  healthy  con¬ 
dition  by  improved  diet  and  medical  treatment.  At  the  first  appearance  of  the  evil  con¬ 
sequences  of  vaccination  I  was  inclined,  with  other  surgeons,  to  believe  that  the  virus 
was  impure,  and,  because  of  this  suspicion,  I  threw  away  the  matter  we  then  had,  and 
obtained  a  vaccine  scab  from  Dr.  Knox,  a  practitioner  on  Church  Hill,  who  assured  me 
he  had  used  it  in  several  cases  with  a  perfect  result. 

The  introduction  of  this  virus  into  the  arms  of  some  ten  patients  resulted  in  the  devel¬ 
opment  of  the  disease  in  question  in  three  of  them,  while  in  the  remainder  it  produced 
apparently  a  true  pustule.  From  this  fact,  and  the  immunity  which  healthy  looking 
men  enjoyed,  I  was  led  to  believe  that  the  predisposing  cause  existed  in  a  vitiated  and 
impoverished  condition  of  the  blood,  and  so  reported  in  my  first  report,  and  that  the  in¬ 
troduction  of  pure  virus  into  the  system  was  the  exciting  cause  of  a  latent  disease.  This 
view,  I  see,  is  also  held  by  Surgeon  Frank  A.  Ramsey,  of  the  Department  of  East  Ten¬ 
nessee,  in  a  communication  on  tile  in  office  of  Surgeon  General.”  This  view  I  have  never 
had  reason  to  change,  though  I  am  aware  that  many  men,  apparently  in  health,  have 
suffered  from  the  effects  of  vaccination. 

In  one  case,  which  I  here  quote,  the  influence  of  a  good  condition  of  the  general  system 
seems  to  have  exerted  a  wonderfully  modifying  influence. 

Case  No.  29. — J.  L.  Turner,  a  private,  Company  G,  Fifth  Virginia  Cavalry,  aged  27, 
married,  parents  healthy — he  himself  enjoying  good  health — never  had  any  venereal  dis¬ 
ease.  Entered  the  service,  April,  1861 — has  been  in  service  ever  since,  was  vaccinated 
about  a  month  ago,  when  in  hospital  at  Farmville. 

This  patient,  Turner,  was  vaccinated  last  winter  by  Assistant  Surgeon  Vaiden,  of  this 
division.  It  not  having  any  effect  upon  his  system,  and  feeling  assured  from  this  and 
previous  vaccinations  that  he  was  proof  against  the  effect  of  it,  he  insisted  upon  being 
vaccinated  by  Assistant  Surgeon  Moses,  from  the  effects  of  which  he  has  suffered  since, 
and  for  which  he  was  on  the  eighth  of  September  admitted  to  this  hospital,  presenting 
the  following  appearance:  A  number  of  pustules,  resembling  impetigo,  on  left  arm  and 
leg,  which  were  developed  in  successive  crops,  appearing  as  soon  as  the  original  pustule 
began  to  heal.  This  was  a  remarkably  mild  form  of  the  disease,  and  was  improving  on 
cod  liver  oil,  when  he  was  furloughed  on  the  twentieth  of  September,  being  a  paroled 
prisoner.  This  patient  was  young,  vigorous  and  comparatively  healthy  when  he  received 
this  vaccine  into  his  system. 

The  search,  for  parasitic  or  cryptogamic  vegetation,  wdth  a  good  microscope,  revealed 
none.  The  pustule  was  seldom  developed  where  parasites  make  their  habitation,  namely, 
in  the  bulbs,  or  at  the  roots  of  the  hair.  The  pus  presented  microscopic  characteristics 
of  pus  globules  floating  in  a  homogenous  fluid.  These  globules  were  not  as  abundant  as 
in  laudable  pus,  and  not  so  distinctly  nucleated,  and  were  irregular  in  outline  in  some  of 
the  cases  examined.  This  appearance  of  globules,  however,  often  exists  in  healthy  or 
laudable  pus,  when  it  has  been  exposed  to  air  anj  length  of  time.  In  the  many  cases  I 
have  examined,  I  have  yet  to  find  a  patient  who  will  acknowledge  that  he  has  had  any 
syphilitic  disease  at  any  period  of  his  life,  though  many  of  them  have  had  gonorrhoea. 
This  exemption  from  syphilis,  howe’ver,  is  not  strange,  since  it  is  a  very  uncommon  dis¬ 
ease  in  the  rural  parts  of  our  country,  the  inhabitants  of  which  comprise  the  very  large 
majority  of  our  army.  We  also  know  that  the  tendency  of  the  secondary  form  of  syph¬ 
ilis  is  to  develop  itself  in  the  forehead,  chest,  back,  and  trunk,  generally,  and  yet  no 
cases,  developed  upon  these  parts  of  the  body,  have  presented  themselves  to  my  observa¬ 
tion.  Many  of  the  patients,  also,  have  suffered  long  enough  to  have  had  the  tertiary 
form  of  syphilis,  developed  nodes,  etc.,  and  yet  no  such  symptoms  have  been  seen  by  me. 

From  what  I  can  learn,  the  Army  of  the  United  States  has  so  far  escaped  these  evil  re¬ 
sults  of  vaccination.  *A  few  cases,  however,  originated  among  the  Federal  officers  in  the 
hospital  of  Libby  Prison,  who  were  vaccinated  in  the  prison  by  one  of  their  surgeons 
from  his  own  arm,  some  weeks  after  their  confinement,  which  presented  all  the  character¬ 
istics  of  the  disease  as  it  has  appeared  in  our  army  I  was  assured  by  these  officers  that 
they  had  neither  seen  or  heard  of  such  a  result  of  vaccination  in  their  army.  Does  not 
this  tact  alone  lead  us  to  infer  that  its  cause  of  origin  may  be  traced  to  some  abnormal 
condition  of  the  blood,  in  these  cases,  induced  by  confinement  in  a  vitiated  atmosphere, 
without  the  means  of  eliminating  the  materies  morbi  from  the  system  by  exercise  and 
care  to  the  function  of  the  skin. 


Spurious  Vaccination  :  Joseph  Jones,  M.  D. 


281 


The  classification  of  this  disease  is  difficult  and  unsatisfactory,  since  it  commences  as  a 
pustule,  and  assumes  often  the  outward  form  of  rupia,  which,  by  all  dermatologists,  is 
classified  among  the  hull;©.  If  we  classify  it  among  the  pustules,  we  find  no  disease 
there  describing  it  accurately,  some  cases  resembling  ecthyma,  others  impetigo.  Inas¬ 
much,  however,  as  it  oftener  assumes  the  characteristics  of  chronic  etchyma,  either  in 
a  mild  or  aggravated  form,  according  to  the  healthy  or  unhealthy  condition  of  the  pati¬ 
ent,  I  propose  to  name  it  vaccine  ecthyma.  Like  all  chronic  cutaneous  diseases,  it  shows 
a  decided  tendency  to  return  whenever  the  system  becomes  reduced  from  any  cause,  or 
when  the  patient  is  exposed  to  causes  which  produce  an  undue  action  in  the  circulation 
of  the  capillary  system.  An  undue  amount  of  exercise  in  warm  weather  seems  to  excite 
its  appearance.  This  was  illustrated  in  those  soldiers  supposed  to  be  thoroughly  cured, 
and  who  were  about  to  be  ordered  to  their  regiments  for  duty,  when  a  raid  was  threat¬ 
ened,  in  the  month  of  July,  upon  the  city  of  Richmond.  These  men  were  among  the 
volunteers  from  the  hospital  to  defend  the  city,  and  were  marched  through  a  hot  sun 
some  four  miles  to  the  lines  at  the  extreme  limits  of  the  western  end  of  the  town.  They 
returned  with  a  new  crop  of  pustules,  which,  however,  healed  by  resolution  in  a  short 
time. 

Treatment — There  is  every  reason  to  believe  that  the  disease  results  from  a  blood  dis¬ 
ease,  only  to  be  eliminated  from  the  system  by  enriching  the  blood  and  supplying  its 
deficiency  of  fatty  matter  with  rich  nutritious  food,  and  by  the  judicious  use  of  altera¬ 
tives.  It  is  in  vain  to  treat  the  ulcers  locally,  for  without  alterative  treatment  with 
nutritious  diet,  all  the  local  applications  which  were  tried  seemed  to  aggravate  rather 
than  improve  them;  hut  as  soon  as  the  general  condition  began  to  improve,  so  did  the 
ulcers.  The  milder  cases  began  to  improve  a  few  weeks  after  admission  without  any 
treatment,  except  dietetic,  in  conjunction  with  the  iodide  of  potash,  syrup  iod.  ferri, 
and  sarsaparilla ;  in  others,  merely  applying  simple  dressing  to  the  ulcers,  was  found 
sufficient  to  subdue  it.  Under  this  treatment  all  the  cases  gradually  but  slowly  im¬ 
proved.  In  the  early  part  of  August  we  received  a  large  supply  of  cod  liver  oil,  and  I 
was  thus  enabled  to  test  fully  the  treatment  which  the  supposed  cause  of  the  disease 
naturally  suggested.  Some  few  of  the  patients  could  not  digest  the  oil,  but  those  who 
could  began  rapidly  to  improve,  and  many  were  able  to  return  to  their  regiments,  whilst 
others  were  thought  well  enough  to  be  transferred  to  their  respective  State  hospitals,  in 
compliance  with  an  order  issued  at  that  time.  Those  who  were  unable  to  digest  the  oil 
continued  the  syrup  iod.  ferri,  which  was  thought  the  best  alterative  indicated  in  their 
cases.  Their  improvement  was  scarcely  perceptible.  In  the  early  part  of  September, 
however,  another  effort  was  made  by  them  to  take  the  cod  liver  oil,  which  they  were 
enabled  to  do  in  a  little  whisky;  their  improvement  soon  became  very  evident  to  them¬ 
selves,  and,  though  not  entirely  well,  the  ulcers  are  rapidly  granulating.  No  new  pus¬ 
tules  are  being  developed,  and  the  patients  are  in  a  fair  way  to  recover.  I  have  nodoubc 
that  the  best  remedy  has  been  found  in  the  cod  liver  oil;  and  this,  locally  applied  and 
internally  administered,  with  an  entire  change  of  air  and  nutritious  diet,  will  remove 
and  eventually  eradicate  this  obnoxious  and  filthy  disease  from  the  system. 

From  the  above  mentioned  facts  I  am  led  to  draw  the  following  conclusions  ;  That  the 
disease  is  pustular  at  its  first  appearance ;  that  it  resembles  ecthyma  in  its  general 
character;  that  it  is  but  a  local  manifestation  of  a  general  disorder,  or  vitiated  condition 
of  the  blood  ;  that  this  vitiated  condition  resulted  from  improper  and  spare  diet,  together 
with  inattention  to  cleanliness,  thus  impairing  the  eliminating  functions  of  the  skin  ; 
that  syphilitic  virus  has  had  no  influence  in  producing  the  disease  ;  that  the  morbid 
effects  have  in  most  of  the  cases  resulted  from  deficiency  in  condition,  independent  of 
any  imperfection  in  the  vaccine  virus  ;  that  the  disease  can  only  be  removed  by  those 
means  calculated  to  impx-ove  the  general  condition  and  restore  the  healthy  play  of  all  the 
functions. 

Dr.  James  Bolton,  of  Bichmond,  Virginia,  who  enjoyed  opportunities  for 
the  investigation  of  the  abnormal  phenomena  manifested  by  vaccination  in 
the  Confederate  Army,  of  the  most  extended  and  valuable  character,  attri¬ 
buted  the  so-called  u  spurious  vaccination n  to  several  causes.  We  present 
in  this  connection  that  portion  of  his  reply  which  relates  to  the  influence 
of  diet,  hardship,  exposure  and  corroding  upon  the  progress  of  the  vaccine 
disease,  reserving  the  facts  which  he  adduces  to  establish  the  existence  of 
syphilo-vaccination,  to  section  7,  of  this  Inquiry. 

Richmond,  Va.,  February  25,  1867. 

Joseph  Jones,  M.  D.: 

Dear  Doctor — After  various  delays  I  send  you  my  paper  ou  Spurious  Vaccination  as  it 
occurred  in  the  Confederate  Armies,  only  regretting  that  they  were  not  forwarded  at  au 
earlier  date.  In  addition  to  these,  I  am  engaged  upon  some  practical  suggestions  on 
Vaccination,  and  also  upon  the  subject  of  Syphilo-Vaccinatiou  ;  but  know  not  when  I 
shall  be  able  to  furnish  the  papers.  Very  truly  yours,  JAMES  BOLTON,  M.  D. 


282 


Spurious  Vaccination :  Joseph  Jones ,  M.  T>. 


During  the  years  1863-4,  a  wide-spread  epidemic  of  small-pox  broke  out  in  the  South¬ 
ern  States.  It  was  impossible  to  supply  the  demand  for  vaccine  virus.  Especially  was  this 
the  case  in  the  Confederate  army,  which  was  panic-stricken  by  the  spread  of  the  disease. 
An  order  for  virus  was  sent  to  England  through  the  blockade.  It  either  was  never  sent, 
or  was  captured.  A  supply  was  sent  through  the  lines  by  the  Federal  authorities  ;  but 
this  was  totally  insufficient  for  the  wants  of  the  prisoners  alone.  Under  orders  from  the 
Surgeon-General  in  Richmond,  the  writer  was  engaged  in  propagating  virus  among 
healthy  children,  and  vaccinating  the  employes  of  the  various  departments  of  the  Gov¬ 
ernment.  The  reports  of  these  vaccinations* * * §  showed  that  more  than  thirteen  hundred 
persons,  chiefly  adults,  had  availed  themselves  of  the  powerful  influence  of  the  prophy¬ 
lactic  agent,  and  that  of  these,  only  one  failed  to  obtain  perfect  protection.  In  that 
single  instance,  the  varioloid  eruption  appearing  two  or  three  hours  after  the  insertion 
of  the  vaccine  virus,  proved  that  the  system  had  already  become  infected  and  that  it 
was  too  late  for  the  vaccine  virus  to  have  exercised  the  least  protective  or  modifying  in¬ 
fluence.  Nearly  all  of  these  persons  had  been  previously  vaccinated.  It  was  observed 
that  the  susceptibility  of  the  system  to  the  virus  was  remarkably  great.  The  presence 
of  the  variolous  poison  in  the  atmosphere  seemed  to  increase  the  susceptibility  of  the 
system  to  the  influence  of  its  antitode.t  By  a  rough  estimate,  the  writer  thinks  that 
two-thirds  of  the  persons  operated  on  exhibited  phenomena  of  vaccinia,  or  of  some 
grade  of  vaccination. \  The  same  samples  of  virus  were  used  upou  nearly  the  whole  of 
these  without  an  unfavorable  result  in  a  single  instance.  Some  of  this  virus,  thus 
tested,  was  given  to  a  Senator  from  Tennessee,  whose  physician  reported,  that  having 
used  the  virus  upon  five  members  of  the  Senator’s  family,  it  produced  no  result  in  four 
cases,  and  those  of  a  spurious  character  in  the  fifth.  The  youth’s  arm  was  almost  cov¬ 
ered  with  scabs  of  different  thickness  at  different  points,  healing  here  and  there,  and 
breaking  out  again,  and  this  succession  presenting  for  many  weeks  subsequent  to  the 
vaccination.  How  can  this  be  explained?  This  same  sample  of  virus  had  been  culti¬ 
vated  and  extensively  propagated  by  the  writer  for  more  than  seven  years,  with  none 
but  normal  results  in  any  case.  The  fault  was,  therefore,  clearly  not  the  virus  as  origi¬ 
nally  furnished.  But  how  had  this  virus  been  preserved  ?  It  may  have  been  kept  for 
some  time  about  the  person,  exposed  to  heat  and  moist  exhalations  from  the  surface. 
These  circumstances,  most  favorable  to  decomposition,  may  have  caused  a  putrescent  state 
in  the  vaccine  crust.  ||  This  crust  would  of  course  produce  a  putrescent  zymosis  in  the  pa¬ 
tient,  or  an  eliminative  action,  or  it  would  be  successfully  resisted,  and  then  its  effects 
would  be  nil.§  Or  it  may  be  explained  in  another  way.  There  may  have  been  some 
occult  influence,  atmospheric  or  some  other,  so  affecting  the  constitution  of  these  per¬ 
sons  at  the  time  that  true, vaccine  zymosis  was  prevented  or  perverted.  At  this  exigency 
the  writer  offered  to  supply  the  Medical  Department  with  an  abundance  of  pure  vaccine 
virus.  Having  received  instructions  from  Surgeon -General  S.  P.  Moore, If-  he  traveled 
for  four  weeks  among  the  plantations  in  the  interior  of  Virginia,  vaccinating  whites  and 
negroes,  and  retracing  his  steps  for  the  purpose  of  gathering  the  crusts.  The  result  of 
this  expedition  was  about  eight  hundred  crusts,  mostly  from  healthy  negro  children. 
This  was  distributed  extensively  through  the  army,  and  no  further  reports  reached  the 
writer  of  abnormal  results.  Among  all  the  children  vaccinated  during  this  tour,  one 
only  presented  abnormal  phenomena,  viz  :  its  face  and  the  vaccinated  arm  were  covered 
with  impetigo.  This  child  was  a  mulatto,  of  a  strumous  appearance. 

Dr.  Ramsey,  Medical  Director  at  Knoxvillle,  Tenn.,  reported  that  many  cases  of  spurious 
vaccination  having  occurred  at  that  post,  a  civil  physician,  of  high  repute,  was  employed 
to  obtain  a  supply  of  reliable  vaccine  virus  from  healthy  infants  in  that  city  and  its 
environs.  Notwithstanding  thogreatest  care  was  taken,  the  virus  thus  obtained  produced 
no  effect  in  some  instances,  and  in  others  it  was  followed  by  erysipelas  and  other  cutaneous 
eruptions.  Dr.  Ramsey  reports  unpleasant  abnormal  exhibits  recently  observed  to  suc¬ 
ceed  the  insertion  of  real  or  presumed  vaccine  virus.  “These  exhibits  are  not  alone  ery¬ 
sipelatous,  but  are  in  many  instances  a  nondescript  furfurraceous  condition  of  the  skin, 
presenting  in  flakes  from  the  size  of  meal  particles  to  that  of  a  fish  scale,  and  a  much 
larger  number  of  instances  of  rupia — sores  of  irregular  shape  and  size,  penetrating  deep 
in  the  tissues,  and  thickening  black  scales  occurring  at  points  remote  from,  as  well  as  at 


*  It  is  much  to  be  regretted  that  the  reports  of  Vaccinations  in  the  Confederate  Army,  including  those 
of  Spurious  Vaccination,  were  destroyed  by  the  fire  which  occurred  in  Richmond,  Va  ,  on  the  night  of  its 
evacuation  by  the  Confederate  troops,  and  that  an  elaborate  paper  on  Spurious  Vaccination,  by  the  writer, 
was  wantonly  destroyed  by  Federal  soldiers. 

1 1  have  observed  this  on  other  occasions. 

%  Of  these,  two  persons  had  been  inoculated  with  genuine  variolous  matter  in  childhood. 

||  The  vaccine  crust  being  used  almost  exclusively  at  the  South,  in  consequence  of  its  retaining  its  proper¬ 
ties  for  a  longer  period  than  the  died  lymph,  and  furnishing  a  more  abundant  supply  of  virus,  will  be  always 
understood  as  the  only  form  of  virus  alluded  to,  unless  otherwise  stated. 

§  This  I  acknowledged  to  be  entirely  theoretical,  as  I  have  no  facts  to  prove  such  a  deterioration,  and 
consequent  zymosis  ever  to  have  taken  place. 

H  The  labors  of  this  gentleman  in  the  cause  of  suffering  humanity,  whether  in  the  form  of  friend  or  foe, 
entitle  him  to  high  rank  in  the  roll  of  philanthropists , 


Spurious  Vaccination :  Joseph  Jones ,  M.  T>. 


283 


the  point  of  which  the  real  or  presumed  vaccine  virus  had  been  inserted.  In  many  cases 
of  the  erysipelatous  exhibits  sloughing  of  the  tissues  occurred  to  an  enormous  extent, 
even  to  the  destruction  of  the  part  for  use.  *  *  *  These  exhibits  have  been  observed 

in  every  State  of  the  Confederacy,  in  every  Department  from  the  Potomac  to  the  Mis- 
sisisppi.  They  have  been  observed  to  follow  the  insertion  of  virus,  which  when  inserted 
into  other  persons  was  followed  progressively  by  pimple,  vesicle,  cellular  pustule,  drying, 
small  in  diameter  with  dark-brown  or  deep  mahogany,  but  semi-opaque,  color  ;  the 
whole  complete  in  from  sixteen  to  twenty-one  days,  and  regarded  by  me  as  regular  vac¬ 
cine  disease.”  *  *  *  *  These  abnormal  exhibits  "do  not  depend  on,  or  proceed  from, 

any  quality  essentially  pertaining  to  the  virus  which  was  used,  but  result  from  an  epi¬ 
demical  cause,  the  impress  of  which  is  made  efficient  or  active  bv  the  co-operation  with 
a  virus.  The  old  doctrine  of  predisposing  and  exciting  causes.” 

When  the  Army  of  Northern  Virginia  lay  around  Fredericksburg,  after  the  first  battle 
at  that  place,  a  large  number  of  spurious  vaccinations  occurred  among  the  soldiers.  These 
appeared  to  be  abnormal  results  of  true  vaccinations.  Large  numbers  were  sent  to  the 
hospital,  and  many  remained  in  a  disabled  condition  for  several  weeks,  the  ulcers  show¬ 
ing  no  disposition  to  heal.  The  army  was  ordered  to  move  northward,  and  most  of  the 
men  quitted  their  beds  and  joined  the  ranks.  All  these  cases  got  well  on  the  march.  In  this 
instance  it  was  evident  that  the  abnormal  results  were  due  to  the  condition  of  the  sys¬ 
tems  of  the  men. 

S.  Fi.  Habersham,  Surgeon  in  charge  of  the  Second  Division  of  Chimborazo  Hospital, 
reported  that  many  cases  of  spurious  vaccination  occurred  at  that  institution.  In  con¬ 
sequence  of  the  prevalence  of  small-pox,  orders  were  given  by  Surgeon-General  Moore, 
to  vaccinate  the  patients  whenever  the  condition  of  their  systems,  impaired  by  disease 
or  wounds,  would  admit  of  it.  Observing  that  the  virus,  with  which  the  hospital  was 
supplied,  produced  abnormal  results,  a  physician  of  high  respectebility  residing  in  the 
neighborhood,  was  employed  to  procure  genuine  virus  from  the  arms  of  healthy  infants, 
for  the  use  of  the  hospital.  The  virus  thus  procurred  perfectly  normal  results  in  some 
instances,  and  abnormal  results  in  others  Surgeon  Habersham  remarks  : 

“The  character  of  all  the  cases  which  have  come  under  my  observation  approximate  more  impetigo  sparsa 
of  an  aggravated  character  than  any  other  disease.  The  disease  is  evidently  constitutional,  as  a  pustule 
may  be  produced  in  many  cases  simply  by  the  scratch  of  a  pin  in  other  parts  of  the  person.  I  am  by  no 
means  satisfied  that  the  disease  has  originated  by  the  use  of  impure  virus,  inasmuch  as  three  cases  were 
developed  in  this  hospital  as  early  as  December,  1862,  in  patients  who  had  been  vaccinated  with  virus  which 
in  other  subjects  produced  a  perfect  vaccination  with  no  ulterior  evil  consequences.  It  will  be  seen  that 
many  of  the  foregoing  cases  were  developed  in  men  who  stated  that  they  were  perfectly  healthy  up  to  the 
time  of  their  vaccination.  My  expeiience,  however,  is  that  in  the  cases  developed  in  the  hospital  the  pa¬ 
tients  were  in  bad  health,  and  of  broken-down  constitutions,  with  a  very  impoverished  condition  of  blood. 
Under  this  impression,  vaccination  was  withheld  from  such  patients  until  their  general  health  had  been 
restored,  when  vaccination  was  practic'  d  without  any  evil  results . 

“A  close  inquiry  into  the  cause  and  origin  of  the  disease  will  reveal  facts,  I  am  inclined  to  believe,  which 
will  show  that  the  predisposing  cause  exists  in  some  peculiarly  vitiated  condition  of  the  vital  fluid,  and  that 
the  exciting  cause  is  the  insertion  of  vaccine  virus.” 

As  a  strong  corroborative  evidence  of  the  truth  of  these  opinions, Dr.  Habersham  states 
-that  about  this  time  a  considerable  supply  of  cod  liver  oil  was  brought  in  through  the 
blockade,  that  a  liberal  supply  was  sent  to  Chimborazo  Hospital,  that  he  placed  the  pa¬ 
tients  suffering  from  spurious  vaccinia  upon  the  use  of  this  valuable  assimilative  mate¬ 
rial,  and  that  they  all  rapidly  recovered. 

The  following  reports  illustrate  some  forms  of  the  disease  upon  which  these  remarks 
were  ba'sed : 

“Case  X — Private  W,  J.  Smith,  Company  A,  Sixtieth  Georgia  Infantry,  aged  twenty -two  ;  by  occupa¬ 
tion  a  farmer  ;  has  suffered  from  an  eruption  of  the  skin  for  about  two  months  ;  was  never  healthy,  having 
suffered  from  debility  for  a  long  time  ;  born  of  healthy  parents  ;  was  vaccinated  about  the  middle  of  Janu¬ 
ary.  1863,  in  General  Hospital,  at  Danville,  bv  surgeon  in  charge.  Vaccination  performed  in  both  arms,  on 
the  left  first,  and  about  ten  days  afterwards  on.  the  right.  Both  punctures  produced  pustules,  which  healed 
in  about  two  months,  leaving  dark  cicatrices.  He  was  then  returned  to  duty.  About  two  months  after¬ 
wards  a  pustule  formed  on  the  upper  edge  of  the  cicatrix  on  the  left  arm.  Eight  pustules  formed  success¬ 
ively  around  the  first  secondary  pustule  (which  gradually  coalesced  into  one  scab),  similar  to  the  eruption 
of  variola  confluense. 

“  Patient  admitted  into  hospital  May  27,  1863,  presenting  an  eruption  of  five  pustules  on  the  right  arm, 
and  one  near  the  wrist,  one  two  inches  below  the  bend  of  the  elbow,  ai  d  three  above  the  elbow,  which 
were  covered  with  thick,  elevated  scabs,  from  beneath  which  a  saneous  and  ichorous  pus  was  discharged, 
similar  in  character  to  impetigo  sparsa.  General  health  bad.  system  emaciated  and  anemic.  Treatment — 
iodide  of  potassium  internally.  General  health  and  character  of  pustules  improving.” 

In  other  cases  the  eruption  made  its  appearance  on  the  lower  extremities. 

The  following  report  illustrates  a  class  of  cases  unaccompanied  by  eruption  or  evi¬ 
dence  of  zymosis  extending  to  other  parts  of  the  system. 

“Case  1. — June,  1863 ;  Henry  H.  Burnett,  private,  Company  A,  Sixth  Georgia  Infantry,  admitted  May 
2,  1863,  with  ulcer  on  left  arm,  about  two  inches  long  by  one  inch  wide.  It  was  very  much  elevated  above 
the  general  surface,  and  upon  it  there  was  a  hard,  black  scab,  which  was  loosely  attached  at  the  base,  and 
from  all  points  issued  a  thin,  ichorous  discharge.  The  patient’s  general  health  was  bad,  and  he  was  very 
anaemic.  He  states  that  he  was  vaccinated  in  camp  on  the  fifteenth  of  April,  by  the  Assistant  Surgeon 
(does  not  remember  name)  of  the  Sixth  Georgia  Itegiment,  with  virus  supposed  to  be  good  :  that  his  health 
was  bad  at  the  time,  just  convalescing  from  an  attack  of  dysentery  :  that  the  third  day  after  the  operation 
the  arm  became  very  much  inflamed  from  the  elbow  to  ih^  shoulder)  which  laBted  about  a  week,  during 


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■which  time,  or  soon  thereafter,  the  ulcer  extended  and  assumed  the  size  and  shape  that  it  presented  -when 
admitted  to  hospital.  The  patient  was  put  upon  the  iodide  of  potassum,  gr,  x,  three  times  per  day,  with  the 
syrup  of  sarsaparilla  and  generous  diet  The  arm  was  poulticed  until  the  scab  came  away.  It  presented  a 
cupped  appearance,  corresponding  to  the  elevated  and  fungoid  base,  and  has  all  the  characteristics  of  an  in 
dolent  and  chronic  ulcer,  which  being  freely  cauterized,  improved,  and  the  patient  is  now  convalescent. 

“The  patient  states  that  he  was  born  of  healthy  parents,  but  lost  a  'brother  with  consumption;  that  he 
entered  the  service  on  the  eighteenth  of  February,  1862  :  did  not  enter  the  service  at  the  commencement  of 
hostilities  because  of  bad  health,  Which  has  improved  since.” 

During  tlie  latter  part  of  the  year  1862,  and  the  early  part  of  1864,  up  to  the  fall  of 
Richmond,  the  citizens  suffered  for  the  want  of  provisions,  from  the  destruction  of  sup¬ 
plies  by  raiding  parties,  difficulty  of  transportation,  and  depreciation  of  currency.  In¬ 
stances  of  scurvy  occurred  among  the  citizens.  At  this  time  cases  of  spurious  vaccinia 
occurred,  of  which  the  following  is  an  illustration:,. 

“Case  1*.— January,  1863;  vaccinated  a  white  woman,  who  resided  on  Third  street,  near  the  cemetery, 
and  on  the  same  day  her  adopted  child,  a  girl  about  six  years  old.  Both  were  primary  vaccinations  and  from 
the  same  virus.  The  vaccine  disease,  which  appeared  on  the  child  about,  the  fifth  day,  went  regularly 
through  its  stages.  It  was,  iu  fact,  a  perfect  vaccination,  but  in  the  woman  it  was  quite  different.  When 
I  examined  her  arm  four  days  after  the  operation  there  was  an  excrescence,  a  spongy  sore.  I  told  her  as  it 
had  failed  to  take,  I  would  vaccinate  her  from  the  child  at  the  proper  time.  About  ten  days  after  this  I 
was  sent  for  to  treat  her  arm,  which  presented  an  ulcer  of  an  inch  in  diameter,  with  incrustations,  from 
which  was  discharged  some  healthy  pus.  She  accused  me  at  once  of  having  used  impure  virus,  but  the  case 
of  the  child  protected  me.  Considering  the  ulcer  the  result  of  some  vice  of  system  (though  I  could  obtain 
no  evidence  from  her  of  this),  I  treated’ the  case  with  five-grain  doses  of  iodide  of  potassium  and  stimulants, 
and  applied  the  ointment  of  the  nitrate  of  mercury  dilute  to  the  part,  after  it  had  been  cleansed  by  a  flax¬ 
seed  poultice.  The  sore  proved  of  a  very  indolent  character  until  the  treatment  had  been  used  for  two 
weeks,  when  it  began  to  improve,  and  finally  healed.  From  her  character  I  inferred  she  had  had  syphilis. 
I  vaccinated  from  the  scab  of  the  child  without  success.” 

It  appears  from  the  foregoing  reports  that  in  some  cases  the  pure  vaccine  virus  was 
absorbed  by  a  system  in  an  unhealthy  condition,  and  produced  the  normal  phenomena 
of  vaccinia;  but  the  sequelae  were  abnormal.  In  some  instances  latent  disease  appears 
to  have  been  developed,  in  others  the  system  had  not  sufficient  recuperative  power  to 
restore  the  injured  part  to  its  former  condition,  and  hence  ill-conditioned  ulcers  showing 
no  disposition  to  heal  were  left  by  the  falling  scab.  In  all  these  cases  there  was  no 
abnormal  contagious  disease  propagated  by  or  originating  in  vaccine  virus. 

The  resulting  vaccinia  was  perfectly  protective  ;  only  the  sequelae  were  abnormal. 
When  the  virus  was  used  from  these  cases,  of  which  the  records  are  not  numerous  or 
clear,  it  produced  spurious  results.  These  phenomena  appeared  to  be  only  the  conse¬ 
quence  of  the  resisting  or  eliminating  efforts  of  the  part,  in  order  to  guard  the  system 
against  the  introduction  of  an  animal  poison.  In  one  instance  there  may  have  been  an 
evanescent  inflammation,  and  in  another  a  true  zymotic  action  not  producing  vaccinia, 
but  an  ulcer  difficult  to  heal.  In  the  former  case  the  vital  powers  were  more  energetic, 
or  the  blood  was  in  a  more  healthy  condition  ;  in  the  latter  these  powers  were  more  feeble 
and  the  blood  was  less  healthy.  Both  of  these  states  were  due  to  circumstances  of  nutri¬ 
tion,  exposure,  fatigue,  moral  condition,  etc. 

Beside  these  cases  others  occurred  of  a  far  more  formidable  character. 

After  tlie  trial  of  Wirz  I  published  a  small  volume,  eutitled :  u  Re" 
searches  upon  Spurious  Vaccination,  or  the  Abnormal  Phenomena,  aeconr 
panying  and  following  Vaccination  in  the  Confederate  Army,  during  the 
recent  Civil  War,  1801-1865,”  in  which  I  examined  the  charge  that  the 
medical  officers  of  the  Confederate  Army  had  deliberately  poisoned  the 
Federal  prisoners  with  poisonous  vaccine  matter. 

Copies  of  this  work  were  sent  to  several  of  the  most  prominent  Generals 
and  medical  officers  of  the  Confederate  Army,  with  the  request  that  they 
would  communicate  such  facts  as  were  in  their  possession  with  reference 
to  the  sufferings  of  the  Federal  and  Confederate  prisoners. 

The  universal  testimony  was  to  the  effect  that  the  sufferings  of  the  Fed¬ 
eral  prisoners  were  due  to  causes  over  which  the  Confederate  Government 
had  little  or  no  control,  and  that  the  sufferings  and  mortality  amongst  the 
Confederate  prisoners  confined  in  Northern  prisons  were  equally  great  and 
deplorable. 

From  this  correspondence  I  select  the  following  letters  from  Gen.  Robert 
E.  Lee  and  other  eminent  citizens  of  the  Southern  States: 

Lexington,  Virginia,  April  15,  1867. 

Dr.  Joseph  Jones : 

Dear  Sir— I  am  much  obliged  to  you  for  the  copy  of  your  “Researches  on  Spurious 
Vaccination,”  which  I  will  place  in  the  library  of  the  Lexington  College. 


*  Reported  by  Dr.  W.  II.  Davis,  of  Richmond,  Virginia. 


« 


Spurious  Vaccination :  Joseph  Jones ,  M.  D.  285 


I  have  read  •with  attention  your  examination  of  the  charge  made  by  the  United  States 
Military  Commission,  that  the  Confederate  surgeons  poisoned  the  Federal  prisoners  at 
Andersonville  with  vaccine  matter. 

I  believe  every  one  who  has  investigated  the  afflictions  of  the  Federal  prisoners  is  of 
the  opinion  that  they  were  incident  to  their  condition  as  prisoners  of  war,  and  to  the 
distressed  state  of  the  whole  Southern  country  ;  and  I  fear  they  were  fully  shared  by  the 
Confederate  piisoners  in  Federal  prisons. 

Very  respectfully,  your  obedient  servant,  E.  E.  LEE. 

Crawfordsville,  Georgia,  April  9,  1867. 

Professor  Joseph  Jones,  M.  D.: 

My  Dear  Sir — Your  esteemed  favor»of  the  third  instant  was  received  to-day.  The  pam¬ 
phlet  came  to  hand  two  or  three  days  ago.  I  am  truly  obliged  to  you  for  both.  I  have 
been  very  much  interested  indeed  with  the  pamphlet,  especially  with  the  matter  on 
pages  13  and  27,  inclusive. 

With  renewed  thanks  and  kindest  regards,  I  remain  yours  truly, 

ALEXANDER  H.  STEPHENS. 

Mr.  Alexander  H.  Stephens,  formerly  Vice  President  of  the  Southern 
Confederacy,  thus  alludes  to  this  subject  in  his  great  work,  u  A  Constitu¬ 
tional  View  of  the  Late  War  Between  the  States  f 

“The  condition  of  those  at  Andersonville  at  the  time  was,  indeed,  most  pitiable  and 
deplorable.  A  very  correct  idea  of  itis  given  in  the  report  of  Dr.  Joseph  Jones,  the  very 
learned  and  eminent,  as  well  as  philanthropic  surgeon,  who  voluntarily  devoted  months 
of  his  time  to  the  alleviation  of  their  maladies  and  miseries.  In  speaking  of  their  gen¬ 
eral  condition  he  says  : 

“  ‘  Surrounded  by  these  depressing  agencies,  the  postponement  of  the  general  exchange 
of  prisoners,  and  the  constantly  receding  hopes  of  deliverance  through  the  action  of 
their  own  government,  depressed  the  already  desponding  spirits,  and  destroyed  those 
mental  and  moral  energies  so  necessary  for  a  successful  struggle  against  disease  and  its 
agents.  Home  sickness  and  disappointment,  mental  depression  and  distress  attending 
the  daily  longings  for  an  apparently  hopeless  release,  appeared  to  be  as  potent  agencies 
in  the  destruction  of  these  prisoners  as  the  physical  causes  of  actual  disease.’  ” 

Savannah,  Georgia,  August  21,  1869. 
Joseph  Jones,  M.  D.,  Secretary  Southern  Historical  Society  : 

Dear  Sir — I  have  had  the  honor  to  receive  your  letter  of  the  second  instant,  and  thank 
you  cordially  for  the  compliment  you  pay  me,  by  “submitting”  for  my  criticism  your 
valuable  paper  on  the  losses  of  the  Confederate  armies  in  the  recent  wax. 

Even  if  my  means  of  obtaining  information  on  the  subject  of  that  paper,  so  interesting 
to  us,  were  equal  to  yours,  I  could  not  venture  to  criticise  your  work;  still  less,  as  the 
fact  is,  that  I  am  without  knowledge  of  the  subject,  or  have  so  little  as  to  justify 
the  above  expression — too  little  to  make  suggestions  to  you,  or  to  pretend  to  offer  you 
information. 

Most  respectfully,  yours  tffuly,  J.  E.  JOHNSTON. 

New  Orleans,  Louisiana,  April  11,  1867. 

Dr.  Joseph  Jones : 

Dear  Sir — Your  letter  of  the  third  instant  has  been  received — also  the  accompanying 
pamphlet,  “On  Spurious  Vaccination  in  the  Confederate  Army,”  which  I  will  read  with 
pleasure,  and  for  which  please  receive  my  thanks. 

The  charge  relative  to  poisoning  Federal  prisoners  by  our  surgeons,  at  Andersonville, 
I  never  gave  a  second  thought  to,  as  I  believed  it  to  be  too  absurd  and  ridiculous ;  but 
it  is  well  to  have  refuted  it. 

I  remain  yours,  very  truly,  G.  T.  BEAUEEGARD. 

Charleston,  April  22. 

Joseph  Jones,  M.  D. : 

My  Dear  Sir — Your  letter,  incorrectly  addiessed  to  meat  Columbia,  reached  me  only 
yesterday  in  Charleston  Your  pamphlet  came  several  days  ago,  and  I  am  very  grateful 
for  it,  but  as  I  gave  my  copy  to  a  professional  medico,  I  will  thank  you  for  another.  I 
retained  the  ffrst  copy  long  enough,  however,  to  peruse  it,  and  you  will  find  from  the 
enclosed  printed  notice,  wdiich  I  prepared  editorially  for  the  Charleston  Courier,  that  I 
had,  in  some  degree,  recognized  your  object  in  one  very  important  portion  of  the  work. 
Let  us  hope  that  the  notice,  however  inadequate  to  the  merits  of  your  essay,  will  not  be 
found  uugenial.  Yours,  truly,  •  W.  GILMORE  SIMMS. 

SPURIOUS  VACCINATION. 

We  are  indebted  to  the  author,  Dr.  Joseph  Jones,  M  D.,  Professor  of  Physiology  and  Pathology  in  the 
Medical  Department  of  the  University  of  Nashville,  Tennessee,  for  a  copy  of  an  elaborate  pamphlet,  de¬ 
voted  to  this  most  interesting  subject  of  “  Spurious  Vaccination,”  a  subject  which,  during  the  late  war  in 


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this  country,  grew  to  he  one  of  enormous  proportions,  as  being  one  of  vital  interest  to  the  statistics  of  hu¬ 
manity  and  mortality  in  every  section.  The  curious  and  complicated  history  of  the  abnormal  phenomena 
accompanying  and  following  vaccination  in  the  Confederate  Army,  during  the  war,  and  governed— as 
doubtless  it  was — by  the  melancholy  condition  of  the  army,  under  exposure,  privation,  cold  or  heat,  bad 
food,  crowded  hospitals,  and  the  use  of  salt  meat  without  vegetables  ;  this  is  the  general  topic  of  this  valu¬ 
able  pamphlet,  which  displays  a  great  deal  of  earnest  inquiry,  scrupulous  thought,  and  a  speculation  which 
seems  to  he  built  upon  just  and  plausible  premises,  and  which  is  enforced  by  a  great  body  and  variety  of 
testimony  from  eminent  medical  men  of  equal  reading  and  experience.  But  in  regard  to  the  medical  and 
surgical  value  of  this  work  we  prefer  to  have  the  opinion  of  medical  men,  and  we  have  accordingly  confided 
the  publication — which  covers  136  pages  of  closely  printed  octavo — to  the  hands  of  an  able  friend  and  corre¬ 
spondent,  who  will  probably  afford  us  a  just  and  complete  opinion  of  its  facts  and  theories  at  a  future  day. 

But  there  is  another  point  of  view  in  which  this  pamphlet  is  to  be  regarded,  and  for  which  we  gladly 
welcome  its  publication,  viz  :  The  Historical.  It  will  lie  found,  in  its  uniform  statement  of  facts,  in  its 
statistics  of  mortality,  relatively  among  the  Federal  soldiers  and  our  own,  in  its  very  full  report  of  the  con¬ 
ditions  under  which  our  soldiers  were  treated — in  their  sufferings  from  want,  equally  of  food  and  medicine — 
a  sufficient  answer  to  those  atrocious  slanders,  by  which  it  was  sought  to  make  the  Confederate  Government 
and  people  odious  for  their  misfortunes,  as  if  for  crimes,  and  to  place  to  their  account  those  evils  which 
accrued  wholly  from  the  cruel  and  brutal  policy  of  the  Federal  Government  itself,  throughout  the  progress 
of  the  war.  In  this  point  of  view,  as  a  contribution  to  the  history  of  the  country,  this  pamphlet  merits  to 
be  read  by  every  citizen,  and  to  find  circulation  in  every  region  where  it  is  thought  necessary,  or  proper, 
that  a  lie  should  be  knocked  on  the  head  as  soon  as  possible.  We  thank  Dr.  Jones  for  our  copy  of  this 
valuable  pamphlet,  and  counsel  its  general  circulation. 

Charleston,  South  Carolina,  37  Tradd  Street,  April,  1867. 

Professor  Joseph  Jones,  M.  D. : 

My  Dear  Doctor — Thanks  for  the  copy  of  yonr  “Researches  upon  Spurious  Vaccina¬ 
tion.  ”  Your  labors  in  the  department  of  pathology  and  hygiene  during  the  war  were  fa¬ 
miliar  to  us  all  in  Richmond,  and  the  profession  at  large  must  he  glad  to  find  them  in 
print.  I  trust  your  entire  labors  were  not  lost  among  the  Surgeon-Generals’  documents? 
Mine  were  lost,  hut  I  still  ha  ve  notes  and  material  which  I  may  make  public. 

Hoping  to  hear  from  you  shortly,  I  am,  with  brotherly  and  friendly  feelings, 

Your  obedient  servant,  MIDDLETON  MICHEL. 

Richmond,  Virginia,  April  5,  1867. 

Professor  Joseph  Jones : 

Dear  Sir — I  beg  to  acknowledge,  with  many  thanks,  the  receipt  of  two  numbers  of  the 
“  Nashville  Journal  of  Medicine  and  Surgery  ”  and  your  pamphlet  upon  “  Spurious  Vac¬ 
cination,”  The  last  especially  was  read  with  great  interest,  and  the  profession  owes  you 
a  debt  of  gratitude  for  the  careful  and  masterly  investigation  you  have  given  the  subject. 

I  received  your  letter  in  regard  to  spurious  vaccination,  last  November,  and  was  anx¬ 
ious  to  answer  it,  because  I  had  seen  in  the  army  a  great  many  cases,  and  was  one  of  a 

committee  of  investigation  ordered  by  Dr.  Guild,  and  referred  to  by  Dr. - in  the 

letter  yon  publish  from  him  ;  but  soon  after  yonr  letter  came,  I  left  the  city  to  be  mar¬ 
ried,  and  did  not  get  back  until  it  was  too  late,  1  supposed,  for  an  answer  to  reach  you  in 
time  for  your  article.  My  letter,  however,  would  have  served  only  to  corroborate  what 
you  received  from  Dr.  B.  Yours,  very  respectfully,  HUNTER  McGUIRE. 

First  Military  District,  Richmond,  Virginia,  April  3,  1867. 

Dear  Doctor—  Your  monograph  on  spurious  vaccination  is  just  received.  I  have  looked 
over  the  articles  seriatim  as  they  appeared  in  your  journal,  with  very  great  interest.  At 
the  same  time,  I  am  compelled  to  say,  that  you  have  failed  to  (fonvince  me  of  the  correctness 
of  your  conclusions.  I  am  prepared  to  show,  and,  I  think,  by  clear,  convincing  evidence, 
that  vaccine  virus  never  conveys  any  other  disease  or  morbific  virus,  that  it  refuses  to 
associate  with  any  other.  I  am  very  anxious  to  complete  my  paper  on  this  subject,  but 
have  been  so  constantly  interrupted  that  1  can  only  look  occasionally,  and  wistfully,  at 
my  unfinished  manuscript. 

If  you  had  done  nothing  more  than  to  have  written  the  second  section  of  your  mono¬ 
graph,  you  would  be  entitled  to  the  everlasting  gratitude  of  every 'Southerner.  There 
is  no  vile  slander  so  extensively  circulated,  and  pertinaciously  insisted  upon  by  our  ene¬ 
mies  as  that  which  declares  that  we  starved  or  otherwise  maltreated  the  prisoners  in  our 
hands.  This  you  have  ably  refuted  in  the  second  section.  I  will  feel  greatly  indebted  to 
you  if  you  will  send  copies  of  your  monograph  to  the  following  gentlemen  :  "Dr.  Edward 
C.  Bolton,  Poughkeepsie,  New  York  ;  Dr.  Abram  Dubois,  No.  13  West  Eleventh  Street, 
New  York;  Dr.  Elisha  Harris,  No.  21  West  Twelfth  Street,  New  York;  Dr.  I.  M.  Minor, 
No.  7  Upper  Gloucester  Street,  Dorset  Square,  London, 

The  last  is  a  native  Virginian,  and  true  as  steel.  I  am  sure  he  will  be  glad  to  be  furn¬ 
ished  with  the  means  of  refuting  the  foul  slanders  where  there  will  be  a  chance  of  hav¬ 
ing  an  impartial  hearing. 

Sometime  since  I  forwarded  to  you  my  paper  on  spurious  vaccination  as  it  occurred  in 
the  Confederate  Armies,  and  also  abstracts  from  reports  of  Confederate  surgeons  upon 
the  same  subject,  but  have  received  no  acknowledgment  from  you,  and  fear  my  letter 
may  have  miscarried.  1  would  regret  this  very  deeply,  as  I  have  kept  no  copy. 

You  will,  therefore,  oblige  me  greatly  by  replying  at  your  earliest  convenience  and  re¬ 
lieving  my  anxieties.  If  the  letter  has  not  come  to  hand,  you  will  please  use  all  endeav¬ 
ors  to  recover  it.  Very  truly,  yours,  JAMES  BOLTON,  M.  D. 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


287 


Dr.  Joseph  Jones,  University  of  Nashville. 

P.  S.  You  need  not  trouble  yourself  to  send  a  copy  of  your  paper  to  Dr.  Minor,  of 
London.  If  you  will  send  me  a  copy,  I  will  forward  it. 

Wilmington,  N.  C.,  July  21,  1867. 

Joseph  Jones,  M.  D. : 

My  Dear  Sir — I  am  under  obligations  to  you  for  your  “Researches  upon  Spurious  Vac¬ 
cination,  ”  which  I  will  make  a  subject  of  report  with  other  committee  matter  at  the 
next  annual  meeting  of  our  State  Society  in  April. 

I  am  very  much  pleased  with  the  extensive  research  which  your  work  exhibits,  and 
think  I  can  see  that  many  spurious  vaccinations  observed  by  me,  are  referable  to  rational 
causes,  and  not  much  to  the  method  of  vaccination. 

Spontaneous  vaccinia,  I  am  inclined  to  believe,  occurs  in  this  section  of  North  Carolina 
and  we  are  making  every  endeavor  to  collect  everything  for  a  complete  report.  I  am 
now  testing  some  vaccine  sent  by  Dr.  Wilson,  from  a  spontaneous  vaccine  pustule  from 
one  of  his  cattle  ;  Dr.  Bolton  is  engaged  in  a  similar  investigation. 

If  I  am  not  trespassing  on  your  valuable  time,  I  would  like  to  learn  your  process  of 
inducing  spontaneous  vaccinia. 

Allow  me  again  to  express  my  obligations  to  you,  and  believe  me, 

Very  truly,  yours,  THOMAS  F.  WOOD. 

Our  transactions  will  be  completed  by  the  first  of  August. 


THE  TENNESSEE  MEDICAL  SOCIETY— THIRTY-FOURTH  AN¬ 
NUAL  MEETING. 

IN  THE  BOARD  OF  HEALTH  ROOMS,  ? 

Nashville,  April  10,  1867.  £ 

The  Society  met  pursuant  to  adjournment.  Dr.  Robert  Martin,  President,  in  the  chair. 

AFTERNOON  SESSION. 

The  Society  was  called  to  order  by  the  presiding  officer,  and  the  various  standing  and 
special  committees  appointed  as  follows  : 

On  Publication — Drs.  J.  H.  Callendar,  Joseph  Jones,  of  Davidson,  and  D.  F.  Wright,  of 
Montgomery. 

On  History  of  the  Society — Drs.  J.  E.  Manlove,  W.  K.  Bowling,  of  Davidson,  and  J.  W. 
Richardson,  of  Rutherford. 

On  Registration  of  Births,  Deaths,  etc.,  etc. — Drs.  J.  R.  Buist,  of  Davidson;  E,  B.  Has¬ 
kins,  of  Montgomery;  Daniel  German,  of  Williamson  ;  B.  W.  Avent,  of  Shelby  ;  A.  Jack- 
son,  of  Madison  ;  B.  Frazier,  of  Knox,  and  S.  P.  Crawford,  of  Greene. 

On  Amendment  to  Charter — Drs.  R.  Martin,  C.  K.  Winston  and  W.  A.  Cheatham,  of 
Davidson. 

Dr.  Buist  moved  that  a  committee  of  three  be  appointed  by  the  Chair  to  select  and 
recommend  as  many  as  eight  subjects,  assigned  to  as  many  suitable  writers,  who  will  be 
requested  to  prepare  a  paper  on  each,  to  be  presented  at  the  next  regular  meeting ;  that 
this  committee  report  at  an  early  day,  to  the  President  of  the  Society,  the  results  of  their 
labors,  so  that  he  may  be  able  to  notify  each  appointee.  Adopted,  and  Drs.  Buist,  Eve 
and  Du  Prd  appointed  as  such  committee. 

The  Secretary  read  a  letter  from  Dr.  Lipscomb,  of  Shelby ville,  the.  President  elect, 
regretting  his  inability  to  attend  the  meeting  of  the  Society,  and  submitting  the  follow¬ 
ing  resolutions  for  its  consideration: 

Resolved,  That  although  the  elaborate  researches  of  Prof.  Joseph  Jones  may  have  failed 
to  define  conclusively  the  origin  of  spurious  vaccination,  they  havo  not  failed  to  eluci¬ 
date  the  points  of  vital  importance  intimately  connected  with  vaccination. 

Resolved,  That  Prof.  Jones  has  succeeded  in  collecting  a  sufficient  number  of  facts  to 
overthrow  the  long-accredited  dogma,  that  secondary  syphilis  is  incommunicable  by  in 
oculation. 

Resolved,  That  the  facts  collected  forcibly  illustrate  the  importance  of  using  no  vac¬ 
cine  virus,  except  that  obtained  from  perfectly  healthy  subjects,  as  well  as  manifest  the 
propriety  of  omitting  the  vaccination  of  the  unhealthy. 

Resolved,  That  for  the  zeal,  industry  and  learning  devoted  to  this  subject,  by  which  so 
many  important  facts  have  been  presented,  and  various  points  elucidated,  the  author  is 
entitled  to  the  thanks  of  the  profession. 

The  resolutions  were  unanimously  adopted. 


288 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


SECTION  III— THE  EMPLOYMENT  OP  MATTER  FROM  PUSTULES 
OR  ULCERS  WHICH  HAD  DEVIATED  FROM  THE  REGU¬ 
LAR  AND  NORMAL  COURSE  OF  DEVELOP¬ 
MENT  IN  THE  VACCINE  VESICLE  5 


SUCH  DEVIATION  OR  IMPERFECTION  IN  THE  VACCINE  DIS¬ 
EASE  AND  PUSTULE  BEING  DUE  MAINLY  TO  PREVIOUS 
VACCINATION,  AND  THE  EXISTENCE  OF  SOME  ERUPTIVE 
DISEASE  AT  THE  TIME  OF  VACCINATION.  OR,  IN  OTHER 
WORDS,  THE  EMPLOYMENT  OF  MATTER  FROM  PATIENTS 
WHO  HAD  BEEN  PREVIOUSLY  VACCINATED,  AND  WHO 
WERE  PARTIALLY  PROTECTED,  OR  WHO  WERE  AFFECTED 
WITH  SOME  SKIN  DISEASE  AT  THE  TIME  OF  THE  INSER¬ 
TION  OF  THE  VACCINE  VIRUS. 


PROF.  PAUL  F.  EVE,  M.  D.,  ON  SPURIOUS  VACCINATION— DR.  R.  D.  HAMILTON, 
OF  CHATTANOOGA,  ON  SPURIOUS  VACCINATION  AMONGST  THE  CONFED¬ 
ERATE  FORCES  SERVING  IN  EAST  TENNESSEE— INVESTIGATIONS  OF  DR. 
EDWARD  JENNER,  ON  THE  VARIETIES  AND  MODIFICATIONS  OF  THE  VAC¬ 
CINE  DISEASE— ANSWER  TO  DR.  JENNEIi’S  INQUIRIES,  BY  THE  RECTOR 
OF  LACKHAMSTEAD— OBSERVATIONS  OF  DR.  JAMES  DAVIS,  OF  COLUM¬ 
BIA,  SOUTH  CAROLINA,  ON  THE  VACCINE  AND  VARIOLOID  DISEASE— EX¬ 
AMINATION  OF  THE  DOCTRINE  OF  JOHN  HUNTER,  ON  DISEASED  ACTIONS  - 
AS  BEING  INCOMPATIBLE  WITH  EACH  OTHER-RELATIONS  OF  THE  VAC¬ 
CINE  DISEASE  TO  MEASLES  AND  OTHER  DISEASES,  WITH  THE  OBSERVA¬ 
TIONS  OF  NUMEROUS  AUTHORS— RELATIONS  OF  CHICKEN-POX  TO  SMALL¬ 
POX-HISTORY  AND  PHENOMENA  OF  CHICKEN-POX  (VARICELLA)— DIF¬ 
FERENTIAL  DIAGNOSIS  BETWEEN  VARIOLOID  AND  VARICELLA, 

Whilst  it  might  admit  of  debate,  whether  pure  vaccine  virus,  obtained 
from  persons  never  before  vaccinated,  and  who  manifested  all  the  phe¬ 
nomena  of  the  disease,  and  especially  the  characteristic  febrile  phenomena 
ever  becomes  deteriorated  or  possessed  of  deleterious  properties  in  its 
passage  through  numerous  human  bodies,  not  suffering  with  such  a  conta¬ 
gious  disease  as  syphilis;  on  the  other  hand,  it  cannot  be  denied  that  the 
power  of  vaccination  has  been  impaired  to  a  lamentable  and  almost  incal¬ 
culable  extent  by  a  succession  of  imperfect  vaccinations  ;  and  especially  by 
the  employment  of  matter  from  those  who  have  been  previously  vaccinated, 
or  who  have  suffered  from  small  pox  previous  to  vaccination. 

Vaccination  may  be  rendered  imperfect  by  the  development  of  febrile 
and  other  diseased  states  after  the  introduction  of  the  virus  into  the  sys¬ 
tem,  arising  from  the  action  of  cold,  or  some  cause  producing  constitutional 
disturbances  differing  essentially  from  the  febrile  phenomena  which  mark 
the  progress  and  perfection  of  the  vaccine  disease,  as  well  as  by  its  im¬ 
perfect  and  altered  course  in  those  who  are  partially  protected  by  previous 
vaccination. 

In  the  isolated  condition  of  the  Southern  Confederacy,  cut  off  from  the 
surrounding  world,  and  denied  even  vaccine  matter,  as  u  contraband  of 
war;”  with  the  necessity  of  turning  out  the  entire  fighting  population  to 
repel  invasion,  and  with  the  necessity  of  employing  all  the  available  med- 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


289 


ical  aid,  good,  bad  and  indifferent;  and  with  the  progressive  increase  of 
small-pQx,  it  is  not  strange  that  the  process  of  vaccination  was  not  as  care¬ 
fully  watched  and  tested  as  it  should  have  been ;  and  that  consequently 
much  imperfect  material  circulated  as  vaccine  matter,  which  not  only  afforded 
little  or  no  protection  against  small-pox,  but  also  proved  positively  dele¬ 
terious. 

My  friend,  Professor  Paul  F.  Eve,  M.  D.,  has  recorded  in  his  discussion 
of  certain  questions  relative  to  the  health  of  the  late  Southern  Army,  in¬ 
teresting  observations  upon  spurious  vaccination  ;  and  it  will  be  seen,  from 
the  following  extracts,  that  this  distinguished  surgeon  inclines  to  the  belief 
that  the  abnormal  manifestations  of  the  vaccine  disease  may  be  due,  in  a 
great  measure,  to  the  alteration  of  the  matter  in  consequence  of  its  pass¬ 
ing  through  a  long  succession  of  human  subjects,  and  in  consequence  of 
the  co-existence  of  various  diseases : 

“The  scab  used  in  Atlanta,  which  did  so  much  mischief,  was  soft,  porous  and  spongy, 
of  a  yellowish-brown  color,  resembling  concrete,  impissated  pus.  It  was  not  a  small, 
hard,  compact,  translucent  substance,  like  dried  compressed  glue,  of  dark-mahogany 
color,  requiring,  as  the  genuine  scab  does,  considerable  effort  to  break  it;  neither  did  it 
present  the  clear,  even,  vitreous  aspect  when  fractured,  but  was  bulky,  irregular  and 
crumbling.  In  every  instance,  wherein  vaccination  was  attempted  with  it,  premature 
effects  were  developed.  No  proper  period  of  incubation,  nor  papular  or  vesicular  erup¬ 
tion  was  observed,  but  in  a  few  days,  even  as  early  as  the  second,  inflammation  had  set 
up,  and  by  the  fourth  or  fifth  day,  sores  were  produced,  covered  by  a  thick,  dirty  crust, 
with  an  ichorous  discharge.  Soon  an  ill-constituted  ulcer,  with  perpendicular  edges,  en¬ 
sued,  extending  through  the  dermoid  to  the  cellular  and  muscular  tissues,  and  involving 
the  neighboring  lymphatics.  The  cutaneous  surface  suffered  chiefly,  presenting  large, 
irritable,  very  dark-colored  and  scabby  ulcers.  Sometimes  there  was  one,  in  other  cases 
several,  not  on  the  extremity  only  iuto  which  the  matter  had  been  inserted,  but  on  the 
others,  and  sometimes  on  the  body.  These  cases  were  greatly  aggravated  by  complica¬ 
tions  with  erysipelas,  scorbutis,  syphilis,  itch,  etc.  I  believe  we  had  no  death  from  un¬ 
complicated  case  of  spurious  vaccination,  though  forty  to  fifty  patients  were  treated  in 
thishospital.  *  *  While  every  deviation  from  the  regular  development  of  the 

vaccine  disease  may  be  considered  spurious,  we  yet  understand  now  by  that  term,  a 
pretty  well  defined,  certainly  a  peculiar,  if  not  a  specific  affection,  which  we  have  al¬ 
ready  attempted  to  describe.  * 

Intimately  connected  with  the  nature  of  spurious  vaccination,  is  involved  the  question 
of  its  being  simply  a  local  affection,  or  constitutional  disease.  To  what  are  its  symp¬ 
toms  due ;  to  a  virus,  or  do  they  arise  from  cachexia?  I  am  free  to  confess  that  the  in¬ 
vestigation  of  this  subject  has  caused  me  to  reverse  the  opinion  that  the  effects  of  impure 
vaccination  are  alone  to  be  attributed  to  the  bad  condition  of  the  patient’s  system, 
and  did  not  depend  upon  anything  special  or  specific.  From  repeated  experiments,  it 
is  well  ascertained  that  laudable  pus  when  inserted  into  a  healthy  person  is  inocuous, 
and  should  it  be  used  in  even  a  decomposing  or  concrete  state,  will  not  excite  certain 
uniform  and  peculiar  results.  Impure  blood,  peculiarity  of  constitution,  indulgencies, 
epidemic  influence,  etc.,  etc.,  will  account,  I  know,  for  many  local  disturbances,  but  not 
for  the  origin  of  spurious  vaccination.  In  every  case  it  is  the  result  of  vaccination  with 
impure  virus,  by  careless  or  inexperienced  persons.  In  reference  to  the  nature  of  this 
impurity,  there  is  good  reason  to  believe  that  it  results  from  a  perversion  or  modification 
in  the  vaccine  vesicle.  We  know  heat  destroys  vaccine,  as  well  as  variolous  virus,  and 
it  may  bo  that  excessive  inflammatory  action  changes  the  genuine  vaccine  matter  into 
the  spurious.  Or  it  may  be  this  virus  affected  by  another  disease,  or  the  bad  state  of  the 
system,  or  becoming  nearly  effete  itself,  by  passing  through  numerous  systems  produces 
a  disease  only  resembling  the  true  vaccine.  The  difficulty  of  developing  genuine  vac¬ 
cination  in  one  once  impressed  by  the  spurious,  shows  plainly  the  connection  between 
the  two.” — The  Nashville  Journal  of  Medicine  and  Surgery ,  New  Series;  vol.  1,  1866,  pp.  21-28 


It  will  be  seen  from  tlie  following  interesting  communication  that  Dr. 
Hamilton,  of  Chattanooga,  who  enjoyed  ample  opportunities  for  the  inves¬ 
tigation  of  the  accidents  following  vaccination  in  the  Confederate  Army, 
attributes  much  of  the  spurious  vaccination  to  the  careless  use  of  matter 
from  imperfect  vesicles  or  sores. 


290 


Spurious  Vaccination  :  Joseph  Jones.  M.  T). 


Chattanooga,  January  15,  18G6. 

Prof.  Joseph  Jones : 

Dear  Sir — Your  note  of  the  fifth  was  received  some  time  since.  Sickness,  absence  from 
home,  and  professienal  duties  have  prevented  an  earlier  reply,  which  I  much  regret,  but 
cannot  remedy. 

In  regard  to  the  subjects  named,  I  fear  I  can  afford  but  little  information  worthy  of 
your  consideration. 

Of  what  is  termed  as  “  spurious  vaccination, ”  I  saw  many  instances  during  my  ser- . 
vices  as  Surgeon  in  the  army  ;  and  while  in  charge  of  the  General  Hospital  at  Strawberry 
Plains,  East  Tennessee,  I  was  directed  from  the  Surgeon  General’s  Office,  to  make  a  sta¬ 
tistical  report  of  all  cases  which  had  come  to  my  knowledge.  In  obedience  to  this  order, 

I  had  collected  notes  of  many  cases,  but  shortly  after  came  the  evacuation  of  East  Ten¬ 
nessee,  and  my  engagement  in  a  different  field  of  labor,  so  that  the  report  was  not  made, 
and  most  of  the  notes  which  I  had  accumulated  were  “  lost  or  destroyed  by  unavoidable 
accident.” 

From  the  few  notes  I  have  on  hand,  and  from  such  facts  as  I  can  recall  to  memory,  I 
give  you  herewith  the  general  results. 

All  the  cases,  with  a  few  exceptions,  of  “  spurious  vaccination,”  which  came  under 
my  observation  during  the  -war,  were  reducible  to  one  of  the  three  following  named 
classes : 

1.  A  single  suppurating  ulcer  at  the  point  of  vaccination, 

2.  General  eruptions,  sometimes  single,  sometimes  in  patches  involving  a  considerable 
extent  of  surface,  appearing  during  the  existence  of  the  original  ulcer,  or  after  it  had 
healed. 

3.  General  eruptions  attended  by  suppuration  of  the  lymphatic  glands. 

To  what  extent  these  different  forms  may  be  regarded  as  separate  stages  of  the  same 
development,  I  am  not  prepared  to  say,  and  I  believe  that  no  connection  exists  between 
them  in  such  a  sense.  There  certainly  was  no  discoverable  progression  through  the  dif¬ 
ferent  conditions,  such  as  is  seen  in  some  diseases. 

It  is  evident  that  the  result  of  any  vaccination  or  inoculation  must  depend  upon  one  or 
both  of  the  following  causes  : 

1.  Upon  the  kind  of  virus  used. 

2.  Upon  the  condition  of  the  patient. 

If  vaccine  virus  is  not  used  in  any  particular  instance  the  result  will  be  useless  and 
perhaps  hurtful  to  the  patient.  I  am  forced  to  the  conclusion  that  a  large  majority  of 
the  cases  of  “  spurious  vaccination,”  which  came  under  my  observation  during  the  war, 
were  such  because  of  the  spuriousness  of  the  virus  used.  If,  by  supposed  vaccination, 
a  “  sore”  was  produced  on  the  arm,  the  virus  was  supposed  to  be  “  takiug,”  and  straight¬ 
way  the  matter  was  put  into  other  arms,  and  other  “  sores”  produced,  when,  on  examina¬ 
tion  it  would  be  found  not  one  of  the  arms  gave  evidence  of  vaccination.  The  pustules 
did  not  possess  the  characteristics  of  true  vaccine,  either  in  their  progress  or  in  their 
results.  The  proper  scar  was  not  left  by  them,  nor  the  usual  protection  from  variola 
afforred.  A  portion  of  liquid  or  encrusted  pus,  or  of  epithelium,  was  inserted  in  the  arm, 
and  the  patient  was  presumed  to  be  vaccinated.  In  some  instances  true  vaccine  virus 
was  used  on  persons  whose  systems  were  protected  by  previous  vaccination,  and  the 
matter  from  the  resulting  pustules  when  used  by  others,  became  a  source  of  evil.  Soldiers 
practiced  upon  themselves  from  the  arm  of  one  of  their  number,  whence  came  a  long- 
train  of  evil  results. 

But  there  were  instances  where  portions  of  the  same  scab  produced  in  some  persons 
the  true  vaccine  pustule,  and  in  others  only  the  spurious  eruption,  and  the  explanation 
must  be  found  in  the  condition  of  the  patient.  Just  what  this  peculiar  condition  is,  or 
what  its  causes  are,  we  know  not.  The  questions  concerning  the  influence  of  army  life 
on  the  physical,  mental  and  moral  condition  of  men  recently  taken  from  the  walks  of 
civil  life,  are  many  and  various,  and  as  yet,  I  believe  most  of  us  are  only  “  guessing”  at 
answers.  Every  medical  officer  remembers  how  fatal  among  soldiers,  at  times,  were  com¬ 
plaints  which  are  ordinarily  remediable,  and  that,  too,  when,  at  the  time  of  the  appear¬ 
ance  of  the  disease,  the  soldiers  were  apparently  in  robust  health.  It  will  also  be  remem¬ 
bered  how  very  few  instances  occurred  of  what  would  be  regarded  as  types  of  any  one 
disease,  while  at  the  same  time  a  large  number  of  cases  wTould  be  found.  Nearly  all 
were  more  or  less  modified,  and  some  so  completely  as  almost  to  lose  their  identity.  But 
this  subject  is  too  extensive  for  discussion  at  this  time. 

In  regard  to  the  transmission  of  syphilitic  poison  through  the  process  of  vaccination, 

I  can  recall  to  mind  a  few  instances,  where  I  feel  positively  certain  that  secondary  syph¬ 
ilitic,  eruptions  existed,  and  the  patients  were  equally  in  their  expressed  belief  that  the 
symptoms  came  from  vaccination.  Such  cases  were  always  diagnosticated  as  svpliilitic, 
and  treated  and  relieved  as  such.  My  experience  leads  me  to  put  so  little  faith  in  the 
assertions  of  persons  affected  with  any  venereal  disease,  on  this  subject,  that  I  have  ar¬ 
rived  at  no  rersonable  conclusion,  and  I  can  only  say  with  the  poet — begging  pardon  for 
so  unpoetic  a  connection — “Though  I  canna  see,  I  guess  and  fear.” 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


291 


To  sum  up  then,  in  a  few  words.  First — It  is  my  belief  that  most  of  the  cases  of  so- 
called  spurious  vaccination  resulted  from  the  fact  that  vaccine  virus  was  not  used,  and 
therefore  no  vaccination,  in  the  proper  sense  of  the  term  took,  place.  Secondly — The 
condition  of  the  system,  affected  by  atmospheric  influence,  or  the  kind  of  life  led  by  sol¬ 
diers,  or  by  what  you  will,  so  modified  the  action  of  the  virus  as  to  produce  morbid 
results. 

I  regret  that  circumstances  prevent  a  more  extended  consideration  of  the  subject 
touched  on  in  this  letter,  such  as  their  importance  demands,  and  I  rejoice  to  learn  that 
you  are  preparing  a  Monograph  on  the  same,  and  I  shall  look  forward  with  much  interest 
for  its  appearance  in  print.  Very  truly,  yours,  R.  D.  HAMILTON. 

Dr  Jermer,  in  the  beginning  of  his  inquiries,  felt  the  propriety  of 
watchfulness  ;  and  at  an  early  day  he  distinctly  announced  that  it  was  pos¬ 
sible  to  propagate  an  affection  by  vaccination  conveying  different 
degrees  of  security,  according  as  that  affection  approached  to,  or  re¬ 
ceded  from,  the  full  and  perfect  standard;  he  also  clearly  stated  that  the 
course  of  the  vaccine  pustule  might  be  so  modified  as  to  deprive  it  of  its 
efficacy,  and  that  inoculation  from  such  a  source  might  communicate  an  in¬ 
efficient  protection,  and  that  all  who  were  thus  vaccinated  were  more  or 
less  liable  to  subsequent  small-pox.  He  still  further  maintained  that  fluid 
taken  from  a  genuine  pustule  in  its  far  advanced  stages,  is  capable  of  pro¬ 
ducing  varieties  which  will  be  permanent  if  we  continue  to  employ  it.  Dr. 
Jenner  attached  great  importance  to  the  condition  of  the  skin  at  the  time 
of  the  insertion  of  the  virus. 

In  his  tract  “On  the  Varieties  and  Modifications,  of  the  Vaccine  Pustule 
occasioned  by  an  herpetic  state  of  the  skin,”  he  says,  “  I  shall  here  just 
observe  that  the  most  careful  testimonies  now  lie  before  me  supporting  my 
opinion  that  the  herpetic,  and  some  other  irritative  eruptions,  are  capable 
of  rendering  variolous  inoculation  imperfect,  as  well  as  the  vaccine.” 

One  of  the  entries  in  his  Journal  is  to  the  following  effect :  “  Inoculated  Lady  C.  F.  a  second  time.  It  is 

evident  that  that  affection  of  the  skin  called  red-gum,  deadens  <the  effects  of  the  vaccine  virus.  This  in  fan  ^ 
was  covered  withit  when  inoculated  four  days  ago.  The  shone  thing  happened  to  Mrs.  D's.  infant.” 

In  a  letter  to  Mr.  Dunning,  dated  Berkely,  December  23,  1S0I,  Dr.  Jen¬ 
ner  says : 

“  There  may  he  peculiarities  of  constitution  favorable  to  this  phenomenon.  My  opinion  still  is.  that  the 
grand  interference  is  from  the  agency  of  the  herpes,  in  some  form  or  another  ;  for  I  have  discovered  that  it 
is  very  Proteus,  assuming,  as  it  thinks  ft,  the  character  of  the  greater  part  of  the  irritative  eruptions  that 
assail  us.  I  shall  have  much  to  say  on  this  disease  one  of  these  days.” 

The  reported  failures  of  vaccination,  and  the  occurrence  of  several  vio¬ 
lent  variolous  epidemics  in  different  parts  of  the  country,  induced  him  to 
endeavor  to  rouse  the  attention  of  professional  men  to  those  points,  in  the 
practice  of  vaccination,  which  he  deemed  essential  to  its  success.  With 
such  intentions  he  printed  a  circular  letter  early  in  1821,  which  was  sent 
to  most  of  the  respectable  medical  men  in  England  ;  in  it  he  directed  their 
observation  to  the  three  following  questions: 

“  First.  Whether  the  vaccine  vesicle  goes  through  its  course  with  the  same  regularity  when  the  skin  is 
under  the  influence  of  any  herpetic  or  eruptive  disease,  as  when  it  is  free  from  such  affections  ;  secoudly, 
whether  the  existence  of  such  eruptive  diseases  causes  any  resistance  to  the  due  action  of  vaccine  lymph, 
when  inserted  into  the  arms ;  thirdly,  whether  cases  of  small  pox,  after  vaccination  had  occurred  to  the 
observer,  and  if. so,  whether  such  occurrences  could  he  ascribed  to  any  deviation  in  the  progress  of  the  vac¬ 
cine  pustule,  in  consequence  of  the  existence  of  herpetic  or  other  eruptions  at  the  time  of  vaccination.” — 
The  Life  of  Edward  Jenner,  M.  I)  ,  L.L.  I).,  F.  R.  S.,  etc.,  by  John  Baron,  M,  D.,  vol.  2,  p •  272. 

The  answer  to  these  inquiries,  by  the  rector  of  Leckhamstead,  contains 
facts  of  such  value  in  their  bearing  upon  this  portion  of  the  subject,  that 
we  are  induced  to  reproduce  it  entire : 

Leckhamstead,  Hear  Buckingham,  June  29,  1820. 

Edward  Jenner,  M.  D.: 

Dear  Sir — Your  letter  did  not  reach  Buckingham  till  June  23.  though  dated  the  twelfth.  The  object  ot 
inquiry  appears  to  bo  the  extent  to  which  cutaneous  diseases  reject  or  modify  the  vaccine  virus,  so  as  to 
render  the  efficacy  and  security  doubtful.  I  have  looked  over  a  number  of  copies  of  communications  to  Dr. 
Harvey,  and  will  with  great  pleasure  send  you  the  transcripts  of  the  interference  of  variolous  and  vaccine 
infection  and  the  superceding  power  of  the  latter  if  applied  in  time,  six  of  which  took  place  at  Old  Strat¬ 
ford,  in  1810,  among  the  children  of  one  family,  being  the  whole  time  under  the  same  roof.  The  distress 
and  alarm  at  the  time  wore  extremely  great,  as  the  inhabitants  were  recovering  from  the  measles  when  the 


292 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


small  pox  broke  out.  The  anxiety  of  the  parents  was  such  that  I  was  induced,  contrary  to  my  own  opinion, 
to  vaccinate  several  where  the  fever  of  measles  had  not  completely  subsided  ;  the  consequence  of  which  was 
nothing  more  than  that  the  vaccine  virus  lay  dormant  in  its  cell  till  the  field  was  clear,  and  came  into 
action  two  or  three  days  later ;  but  afterwards  proceeded  in  as  regular  and  decided  a  manner  as  in  constitu¬ 
tions  which  were  not  previously  engaged. 

I  discovered  at  a  very  early  period  that  the  itch  was  not  an  impediment ;  as  to  the  shingles,  I  cannot 
speak.  The  grand  rejecting  agent  in  children  is  the  tooth-rash,  or,  as  it  is  here  commonly  called,  the  red- 
gum,  especially  while  it  continues  bright  and  active.  Dr.  William  Cleaver  (when  Bishop  of  Chester)  pro¬ 
moted  an  extensive  variolous  inoculation  in  his  diocese.  Some  years  after  he  asked  me  if  I  could  account 
for  the  very  frequent  failure  of  communicating  the  affection  to  young  children.  I  told  him  that  it  applied 
equally  to  the  vaccine ;  though  frequently,  if  the  virus  was  fresh  and  active,  it  would  be  suspended  in  its 
career  for  a  time  only,  but  push  forward  with  success  at  last. 

I  beg  to  assure  you,  sir,  that  nothing  I  have  met  with  has,  in  the  slightest  degree,  shaken  my  faith  in 
the  vaccine.  I  have  several  children,  the  eldest  sixteen,  all  vaccinated  by  myself ;  and  of  14,305,  all  within 
a  few  miles  of  this  place,  I  have  never  heard  of  a  single  fatal  disappointment :  and  of  only  two  or  three 
cases  of  modified,  or  what  I  should  feel  inclined  to  call  superficial  or  cutaneous  small-pox.  As  to  remote  or 
deriative  diseases,  I  know  ot  no  such  thing  fairly  to  be  ascribed  to  the  cow-pox;  I  have  ample  means  of 
knowing  if  such  a  thing  had  taken  place,  as  the  people  of  my  two  parishes,  and  many  in  the  neighborhood, 
are,  somehow  or  other,  continually  coming  under  my  consideration  for  medical  assistance.  My  communi¬ 
cations  of  late  years  have  been  to  Dr.  Harvey,  according  to  the  directions  of  the  National  Establishment; 
■but.  I  have  met  with  no  demand  for  inoculation  since  February,  1820,  simply  from  the  absence  of  any  stimu¬ 
lating  alarm.  1  am,  dear  sir,  with  the  highest  respect,  your  most  obedient,  humble  servant, 

T.  T.  A.  REED,  Rector  of  Leckhamstead. 

Mr.  Reed  had,  in  1806,  printed  and  distributed  a  tract  for  the  encourage¬ 
ment  of  those  who  entertained  any  doubt  respecting  the  efficacy  of  vaccine 
inoculation ;  and  distinguished  himself  as  an  ardent  and  successful  pro¬ 
moter  of  vaccination.  His  testimony,  therefore,  is  of  great  value. 

Dr.  Jenner  maintained  to  the  last  hour  of  his  life,  that  any  cutaneous 
disease,  however  slight  in  appearance,  was  capable  of  interfering  with  the 
regular  course  of  the  cow-pox,  and  of  preventing  it  from  exercising  its  full 
protecting  influence  ;  and  his  directions  for  obviating  any  deterioration  of 
the  virus,  regarded  first,  the  character  of  the  pustule  itself,  the  time  and 
quality  of  the  lymph  taken  for  inoculation,  and  all  other  circumstances 
that  might  go  to  affect  the  complete  progress  of  the  disorder.  Thus  lie 
maintained  that  the  vaccine  fluid  should  be  taken,  for  the  purpose  of  inoc¬ 
ulation,  at  an  early  period  of  the  formation  of  the  vesicle,  and  before  the 
appearance  of  the  areola;  and  he  insisted  that  the  pustule,  when  excited, 
should  be  permitted  to  go  through  all  its  stages  in  an  uninterrupted  man¬ 
ner,  and  if  any  deviations  appeared  in  its  progress,  he  always  forbade  the 
employment  of  virus  from  such  a  pustule  for  further  vaccinations. 

Dr.  Waterhouse,  in  a  letter  to  Dr.  Mitchell,  dated  Cambridge,  SeptenT 
ber  26,  1801,  says  :  “  Yesterday  I  received  a  letter  from  Dr.  Jenner,  one 

paragraph  of  which  I  must  transcribe,  because  it  contains  the  golden  rule 
of  vaccination ,  viz  :  ‘I  don’t  care  what  British  laws  the  Americans  dis¬ 
card,  so  that  they  stick  to  this — never  to  talce  the  virus  from  a  vaccine  pustule 
for  the  purpose  of  inoculation,  after  the  efflorescence  is  formed  around  it.  I 
wish  this  efflorescence  to  be  considered  as  a  sacred  boundary,  over  which 
the  lancet  should  never  pass.”  Med.  Repository,  N.  Y.,  vol.  5,  p.  236. 

Every  deviation,  from  whatever  cause  it  may  have  arisen,  was  consid¬ 
ered  by  Jenner  of  the  greatest  moment ;  and  as  has  been  fully  shown  by 
the  learned  author  of  his  life,  in  all  his  published  works,  as  well  as  in 
every  private  communication,  he  never  failed  to  express  his  deep  sense  of 
the  importance  of  the  most  scrupulous  attention  to  that  part  of  the  sub¬ 
ject;  and  to  the  last  he  felt  that,  had  his  admonitions  been  received  as  they 
ought,  had  the  phenomena  connected  with  vaccine  inoculation,  been  studied 
by  all  who  conducted  the  practice,  a  large  proportion  of  the  failures  would 
have  been  avoided. 

i ? 

The  following  important  and  interesting  communication,  published  about 
forty-five  years  ago,  confirms,  in  a  striking  manner,  the  correctness  and 
great  value  of  the  laws  laid  down  by  Jenner,  with  reference  to  the  rela¬ 
tions  of  the  vaccine  disease  to  cutaneous  affections  : 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


293 


OBSERVATIONS  ON  THE  VACCINE  AND  VARIOLOID  DISEASES. 
COMMUNICATED  BY  JAMES  DAVIS,  M.  D.,  OF  SOUTH 
CAROLINA. 

I  offer  you  the  following  communication,  not  only  because  it  seems  to  corroborate  the 
observations  of  Dr.  Jenner  and  others,  that  the  simultaneous  existence  of  cutaneous  dis¬ 
eases,  with  the  vaccine-pox,  has  a  tendency  to  vitiate  the  virus  of  the  latter  disease,  and 
render  it  untit  for  communicating  the  true  kine-pock ;  but,  moreover,  because  it  would 
appear  that  the  vaccine  matter  is  liable,  from  this  circumstance,  to  be  converted  into  a 
virus  of  a  totally  different  character.  *  *  * 

I  extract  the  following  case  from  my  note  book  : 

On  the  twenty-ninth  of  June,  1814,  I  vaccinated  Master  James  D.  Montgomery,  yet. 
eighteen  months,  sou  of  Dr.  B.  R.  Montgomery,  Professor  of  Moral  Philosophy,  etc.,  in 
the  South  Carolina  College,  together  with  six  other  healthy  children.  I  had  obtained 
the  matter  that  I  made  use  of  from  Dr.  Smith,  of  Baltimore.  James  D.  Montgomery  had 
been  laboring  under  a  cutaneous  disease  (the  strophulus  interlictus  of  Willan)  for  about 
three  months.  It  had  resisted  every  remedy  which  I  had  prescribed  for  it,  and  by  this 
time  had  literally  spread  over  the  whole  surface,  so  as  to  render  it  difficult  to  find  a 
sound  spot  on  the  arm  large  enough  for  making  the  insertion.  I  should  have  been  de¬ 
terred  irom  vaccinating  in  such  a  case,  but  for  a  remark  of  Dr.  Jenner,  viz.:  “That 
vaccination,  although  not  very  certain  to  take  in  cases  of  cutaneous  eruption,  yet,  when 
it  did  take,  it  was  curative  of  the  cutaneous  disorder.”  Upon  this  information  I  recom¬ 
mended  it  to  Dr.  Montgomery,  who  readily  acceded  to  the  experiment.  The  vaccine 
failed  to  take  effect  in  every  one  of  the  cases,  except  in  that  of  J.  D.  Montgomery  ;  and 
in  his  case  it  was  really  gratifying  and  delightful  to  observe  the  effect  of  it  on  the  cuta¬ 
neous  disease.  As  the  vaccine  pock  advanced,  the  affection  of  the  skin  disappeared,  and 
that  in  a  very  exact  proportion  to  each  other  ;  so  that,  by  the  time  the  pock  was  mature, 
the  cutaneous  disorder  had  entirely  gone  off.  From  fifteen  to  twenty-five  days  after  the 
kine-pock  had  been  in  its  full  course,  he  was  afflicted  with  two  abscesses,  one  on  his 
back  and  one  on  his  breast,  which  discharged  from  half  an  ounce  to  an  ounce  of  laudable 
pus ;  since  which  time  he  has  remained  in  sound  and  perfect  health. 

His  pock  proved  to  be  anomalous,  and  whether  it  were  sufficient  to  protect  his  system 
against  the  small-pox  has  not  since  been  tested.  But  from  the  constitutional  symptoms 
which  I  attentively  observed,  I  am  very  much  inclined  to  believe  that  as  to  himself  it 
was  effectual. 

The  virus  manifested  no  signs  of  having  taken  effect  until  the  eighth  day,  when  the 
small  inflamed  point  at  the  puncture  first  appeared. 

The  areola  did  not  progress  from  day  to  day  with  regularity,  nor  was  it  at  any  time 
sufficiently  circumscribed,  having  some  radii  considerably  longer  than  others.  Its  color 
was  a  coarse  red,  instead  of  that  beautiful  fine  blush  which  the  genuine  vaccine  gener¬ 
ally  exhibits. 

The  pock,  although  of  ordinary  size,  and  of  a  concave  surface,  was  destitute  of  that 
cordon  of  bead-like  vesicles,  which  form  around  the  corona  of  the  true  kine-pock  It 
was  peculiarly  dry,  insomuch  that  it  was  difficult  to  obtain  from  it  as  much  lymph  as 
would  serve  for  further  vaccination. 

Four  healthy  children  (white  and  black),  of  the  family  of  Dr.  E.  D  Smith,  Professor 
of  Chemistry,  etc.,  were  vaccinated  from  tfiis  pustule.  I  had  expressed  an  opinion,  that 
although  I  believed  the  constitution  of  little  Master  Montgomery  was  secured  against 
the  small-pox,  that,  nevertheless,  I  doubted  of  the  efficacy  of  the  matter  of  his  pustule 
to  communicate  the  true  disease.  As  matter,  however,  was  hard  to  be  obtained,  and  as 
it  was  conceived  no  danger  could  result  from  it,  the  doctor  determined  on  making  the 
trial.  It  failed  to  produce  any  effect  whatever  on  all,  except  on  one  of  the  doctor’s  own 
children.  In  this  case  the  puncture  began  to  inflame  within  the  first  fourteen  hours. 
The  inflammation  spread  rapidly,  accompanied  with  innumerable  papulous  eruptions 
over  the  inflamed  surface,  exuding  a  profuse  quantity  of  gelatinous  matter.  It  continued 
to  spread  for  about  thirty  hours,  assuming  in  its  progress  rather  a  formidable  appear¬ 
ance,  and  exciting  a  good  deal  of  alarm,  until  it  occupied  a  space  longer  than  five  or  six 
areolas  of  true  pock  ;  extending  over  the  one  more  longitudinally  than  laterally.  Aperi¬ 
ents  were  administered,  and  the  topical  affection  fomented  with  a  decoction  of  chamomile 
flowers,  and  in  about  forty-eight  hours  it  had  totally  disappeared,  having  exhibited  no 
sign  whatever  of  anything  like  a  pock.  There  was  no  constitutional  disturbance  accom¬ 
panying  the  affection.  The  child  remained  in  perfect  health,  and  has  undergone  the 
kine-pock  by  a  subsequent  vaccination. 

This  case  evinces  two  facts  in  a  clear  and  decided  manner,  to-wit:  that  the  vaccine 
disease  is  capable  of  effecting  the  cure  of  certain  inveterate  diseases  of  the  skin  ;  and 
that  certain  diseases  of  the  skin  may  exert  an  influence  over  the  vaccine  matter,  as  not 
only  to  vitiate  and  render  it  uuftt  for  communicating  the  true  kine-pock,  but  alsb  abso- 


294 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


lutely  to  change  and  convert  it  into  a  poison  of  a  new  and  unknown  character  Two 
facts  of  great  practical  importance,  and  which,  perhaps,  deserves  more  investigation  and 
scrutiny,  than  they  have  hitherto  received. 

The  influence  of  kine-pock  over  cutaneous  disorders  is  an  old  remark;  and  the  influ¬ 
ence  of  diseases  of  the  skin  in  vitiating  the  matter  of  the  kine-pock,  and  rendering  it  unfit 
for  communicating  the  true  pock,  is  equally  old.  But  its  liability  to  be  converted  into  a 
poison  of  a  different  nature,  productive  of  singular  and  anomalous  affections,  in  conse¬ 
quence  of  being  blended  with  certain  cutaneous  disorders,  is  a  subject  which  lias  not 
hitherto  attracted  as  much  attention  as  it  merits.  In  this  instance,  the  cutaneous  disease 
of  Master  Montgomery  obviously  occasioned  a  conversion  of  the  vaccine  matter  into  a 
new  kind  of  virus,  producing  a  new  and  singular  affection.  It  is  true  it  proved  to  be  a 
mere  topical  affection,  and  terminated  without  any  serious  consequences  ;  but,  as  the 
vaccine  matter  is  liable  to  be  changed  by  one  form  of  cutaneous  disease,  is  it  not  reason¬ 
able  to  conclude  that  it  may  also  be  changed  by  others?  And,  although,  in  this  particu¬ 
lar  case,  it  was  changed  into  comparatively  an  inocuous  virus,  have  we  any  evidence, 
that  in  blending  with  some  others  of  the  multifarious  affections  of  the  skin,  incident  to 
mankind,  it  may  not  become  converted  into  a  virus  of  deleterious  and  destructive  oper¬ 
ation  ? 

All  this,  however,  indicates  nothing  against  the  utility  and  importance  of  genuine  vac¬ 
cination,  but  only  shows  how  important  it  is  that  it  should  be  practiced  with  a  care,  cir¬ 
cumspection,  and  skill,  with  which  the  prevailing  custom  of  our  country  at  present  is 
utterly  incompatible  ;  and  until  there  shall  be  a  reform  effected  in  this  respect,  it  will  be 
in  vain  to  look  for  the  full  extent  of  those  beneficial  results  to  mankind  which  the  kine- 
pock  is  unquestionably  calculated  to  afford. 

The  attainment  of  these  results  in  strict  conformity  with  the  laws  of  our  condition  in 
the  attainment  of  every  other  great  and  important  good,  is  beset  with  difficulties;  nev¬ 
ertheless,  we  have  no  reason  to  suppose  that  these  difficulties  are  insuperable.  Every 
year  brings  to  light  some  new  facts,  which  enable  us  to  approach  nearer  and  nearer  to 
the  attainment  of  the  desired  object.  And  as  one  principal  obstacle  to  the  improvement 
of  our  knowledge  of  this  subject  has  been  the  apathy,  indifference,  and  even  levity, 
with  which  it  has  been  received  by  a  great  majority  of  the  community;  so,  when,  per¬ 
haps,  from  severe  afflictions  and  scourges,  or  from  any  other  cause,  this  supineness  and 
indifference  shall  be  removed  ;  then  the  march  of  improvement  will  be  rapidly  acceler¬ 
ated,  and  great  and  permanent  advantages  will  be  the  happy  result. 

Would  it  not  be  a  wise  precaution,  and  worthy  of  legislative  provisions,  to  impose  a 
penalty  on  any  one  who  should  communicate  the  vaccine  disease  from  an  unhealthy  sub¬ 
ject  ? — The  American  Medical  Recorder  of  Original  Papers  and  Intelligence  in  Medicine  and 
Surgery,  conducted  by  John  Eberle,  M.  D.,  Philadelphia,  and  II.  W.  Ducachet,  M.  D., 
New  York,  vol.  5,  1822 — pp.  208-272. 

The  power  of  the  vaccine  virus  to  relieve  diseases  of  the  skin,  can  only 
depend  upon  its  absorption  into  the  blood,  and  its  effects  upon  the  entire 
system;  and  facts  are  now  wanting  to  show  by  actual  manifestations  of 
the  local  disease  in  other  parts  of  the  system  not  inoculated  with  the  virus, 
that  the  entire  system  as  well  as  the  skin  is  brought  under  the  action  of 
this  poison. 

Dr.  Denby  reported  the  case  of  Henry  Freeman,  a  lad  of  twelve  years 
of  age,  who  was  vaccinated  in  the  left  arm  by  the  usual  mode.  The  vesi¬ 
cle  was  marked  by  the  appropriate  progressive  character  of  successful  in¬ 
oculation.  It  happened  that  on  the  same  day  on  which  he  was  vaccinated 
(five  hours  subsequent  to  that  process,)  an  incised  wound  was  accidently 
inflicted  on  his  right  knee;  which  wound,  for  two  or  three  days  promised 
union  by  the  first  intention.  On  the  fourth  or  fifth  day  ,  however,  an  in¬ 
crease  of  pain  was  felt  in  the  knee,  with  throbbing  and  heat  about  the 
edges  of  the  wound  ;  and,  on  inspection,  some  slight  papulae,  to  the  num¬ 
ber  of  ten  or  thirteen,  were  observed  surrounding  it.  These  appearances 
were  yet  referred  to  a  common  cause.  On  the  eighth  day,  their  peculiar  and 
regular  form  imparted  a  conviction  that  they  were  true  vaccine  vesicles, 
which  they  proved  to  be  by  their  progress  and  maturation.— London  Med. 
Press ,  April,  1825. 

As  far  as  our  knowledge  extends,  the  records  of  Medicine,  are  singularly 
barren  of  critical  observations  upon  the  phenomena  manifested  by  man, 
when  acted  upon,  by  two  or  more  diseases  at  the  Barne  time.  This  imper- 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


295 


fection  of  knowledge  results  not  only  from  the  complexity  of  the  phe¬ 
nomena,  and  the  difficulties  of  the  investigation,  but  also  from  the  com- 
paratively  infrequent  occurrence  of  two  or  more  contagious  diseases,  at 
the  same  time,  in  the  same  household,  and  in  the  same  individual. 

Every  fact  illustrating  the  relations  ot  the  vaccine  disease,  to  other  dis¬ 
eases  arising  simultaneously  in  the  samei  ndividual,  is  of  importance  in  the 
light  which  it  throws  upon  the  modifications  of  the  vaccine  disease,  and 
upon  the  question  of  the  possibility  of  transmitting  various  contagious  diseases 
through  the  medium  of  vaccine  virus. 

The  following  tacts  and  observations  by  various  writers,  bearing  upon 
these  questions,  which  we  have  gathered  up  alter  some  research,  are  pre¬ 
sented  under  this  division  of  our  subject,  to  which  they  naturally  belong, 
rather  for  the  purpose  of  exciting  and  aiding  farther  investigation,  than  as 
full  and  complete  investigations  upon  which  definite  and  uncontrovertible 
principles  may  be  founded.  I  have  myself  conducted  extended  investiga¬ 
tions  upon  the  mutual  relations,  of  various  concurrent  diseases,  as  malarial 
fever,  typhoid  fever,  pneumonia,  cerebro-spinal  meningitis,  hospital  gan¬ 
grene  and  pyaemia,  the  results  of  which  it  would  be  impossible  to  present 
at  the  present  time,  although  related  to  the  subject  now  under  discussion  ; 
and  I  shall  present  those  facts  which  relate  chiefly  to  the  relations  of  small¬ 
pox  and  the  vaccine  disease  to  several  of  the  Exanthemata. 

If  we  accept  without  reserve  the  doctrine  of  John  Hunter,  that  “No  two 
actions  can  take  place  in  the  same  constitution  or  in  the  same  part,  at  one 
and  the  same  time;  no  two  different  fevers  can  exist  in  the  same  constitu¬ 
tion,  no  two  local  diseases  in  the  same  part,  at  the  same  time ;”  (  Works  of  John 
Hunter ,  edited  by  James  F.  Palmer,  London,  1837,  vol.  2,  Treatise  on  the 
Venereal  Disease,  p.  132);  the  question  of  the  modification  of  the  vaccine  dis¬ 
ease  by  concurrent  diseases,  as  well  as  the  possibility  of  the  transmission  of 
contagious  diseases  through  the  medium  of  the  vaccine  virus  is  definitely  set¬ 
tled,  in  the  negetive.  The  unreserved  assent  to  such  a  doctrine  as  this,  is 
wholly  incompatible  with  the  admission  of  the  possibility  of  transmitting 
such  a  disease  as  syphilis  through  the  medium  of  the  matter  produced  by 
a  distinct  disease,  different  in  its  mode  of  origin,  constitutional  action, 
symptoms  and  progress. 

Even  the  renowned  author  of  this  doctrin,  appears  to  have  experienced 
difficulties,  when  he  attempted  to  apply  it  universally.  The  engrafting  of 
other  diseases  upon  the  systems  of  those  who  were  laboring  under  constitu¬ 
tional  syphilis,  and  scurvy,  as  well  as  the  occasional  occurrence  of  these 
two  diseased  states  in  the  same  individual,  presented  at  the  outstep  diffi¬ 
culties  to  the  mind  of  John  Hunter,  which  he  attempted  to  remove  by  argu 
ment.  The  mode,  as  well  as  the  facts,  by  which  Hunter  supported  his  doc¬ 
trine  are  worthy  of  full  consideration,  in  this  connection,  as  gathered  from 
various  portions  of  his  works. 

“0/  diseased  actions ,  as  being  incompatible  with  each  other. — As  I  reckon  every  opera¬ 
tion  in  the  body  an  action,  whether  universal  or  partial,  it  appears  to  me  beyond  a  doubt 
that  no  two  actions  can  take  place  in  the  same  constitution,  nor  in  the  same  part,  at  one 
and  the  same  time  ;  the  operations  of  the  body  are  similar  in  this  respect  to  actions  or 
motions  in  common  matter.  It  naturally  results  from  tliis  principle  that  no  two  different 
fevers  can  exist  in  the  same  constitution,  nor  two  local  disease  in  the  same  part.  There 
are  many  local  diseases  which  have  dispositions  totally  different,  but,  having  very 
similar  appearances,  have  been  supposed  by  some  to  be  ouesort  of  disease,  by  others  to 
be  of  a  different  kind,  and  by  others  again  a  compound  of  two  diseases.  Thus  the 
venereal  disease,  when  it  attacks  the  skin,  is  very  similar  to  those  diseases  which  are 
vulgarly  called  scorbutic  and  vice  versa.  These,  therefore,  are  often  supposed  to  be  mixed, 
"and  to  exist  in  the  same  part.  Thus  we  hear  of  a  pocky-scurvy,  a pocky-itcli,  rheumatic- 
gout,  etc.,  which  names,  according  to  my  principle,  imply  a  union  that  cannot  possibly 
exist. 


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Spurious  Vaccination :  Joseph  Jones ,  M.  I). 


•‘It  lias  been  considered  as  contradictory  to  this  opinion  that  a  patient  might  have 
scrofula,  scurvy,  venereal  disease,  small-pox,  etc.,  at  the  same  time.  All  of  this  is  in¬ 
deed  possible;  but  then  no  two  of  them  can  exist  in  the  same  part  of  the  body  at  t  lie 
same  time  ;  but  before  one  of  them  can  occupy  the  places  of  another,  that  other  must  be 
lirst  destroyed,  or  it  may  be  superseded  for  a  time,  and  may  afterwards  return. 

“When  a  constitution  is  susceptible  of  any  one  disease,  this  does  not  hinder  it  from 
being  also  susceptible  of  others.  1  can  conceive  it  possible  that  a  man  may  be  very  sus¬ 
ceptible  of  every  disease  incident  to  the  human  body,  although  it  is  not  probable  ;  for  I 
should  believe  that  one  susceptibility  is  in  some  degree  incompatible  with  another,  in  a 
manner  similar  to  the  incompatibility  between  different  actions,  though  not  of  so  strict  a 
kind. 

“A  man  may  have  the  lues  aud  the  small-pox  at  the  same  time  ;  that  is,  parts  of  his 
body  may  be  contaminated  by  the  venereal  poison,  the  small-pox  may  at  the  same 
time  take  place,  and  both  diseases  may  appear  together,  but  still  not  in  the  same 
part. 

“In  two  eruptive  diseases,  when  both  are  necessarily  the  consequence  of  fevers,  and 
where  both  naturally  appear  after  the  fever  nearly  at  the  same  distance  of  time,  it  would 
be  impossible  for  the  two  to  have  their  respective  eruptions,  even  in  different  parts,  be¬ 
cause  it  is  impossible  that  the  two  preceding  fevers  should  be  coexistent. 

•‘From  this  principle  I  think  I  may  fairly  put  the  following  queries :  Do  not  the  failure 
of  inoculation,  and  the  power  of  resisting  many  infections,  arise  from  the  existence  of 
some  other  disease  at  that  time  in  the  body,  which  is  therefore  incapable  of  another 
action  ? 

“  Does  not  the  great  difference  in  the  time,  from  the  application  of  the  cause  to  the 
appearance  of  the  disease,  in  many  cases,  depend  upon  the  same  principle?  For  in¬ 
stance,  a  person  is  inoculated,  and  the  puncture  does  not  inflame  for  fourteen  days,  cases 
of  which  I  have  seen.  Is  not  this  deviation  from  the  natural  progress  of  the  disease  to 
be  attributed  to  another  disease  in  the  constitution  at  the  time  of  inoculation  ?  Does 
not  the  cure  of  some  diseases  depend  upon  the  same  principle? — as,  e.  g-,  the  suspension 
or  cure  of  a  gonorrhoea  by  a  fever. 

“  Let  me  illustrate  this  principle  still  further  by  one  of  many  cases  which  have  come 
under  my  own  observation.  On  Thursday,  the  sixteenth  of  May,  1775,  I  inoculated  a 
gentleman’s  child,  and  it  was  observed  that  I  made  pretty  large  punctures.  On  the  Sun¬ 
day  following,  yiz.,  the  nineteenth,  he  appeared  to  have  received  the  infection,  a  small 
inflammation  or  redness  appearing  around  each  puncture  and  a  small  tumor.  On  the 
twentieth  and  twenty-first  the  child  was  feverish;  but  I  declared  it  was  not  the  variolous 
fever,  as, the  inflammation  had  not  at  all  advanced  since  the  nineteenth.  On  the  twenty- 
second  a  considerable  eruption  appeared,  which  was  evidently  the  measles,  and  the  sores 
on  the  arms  appeared  to  go  back,  becoming  less  inflamed. 

“  On  the  twenty-third  he  was  very  full  of  the  measles  ;  but  the  punctures  on  the  arms 
were  in  the  same  state  as  on  the  preceding  day.  On  the  twenty-fifth  the  measles  began 
to  disappear.  On  the  twenty-sixth  and  twenty-seventh  the  punctures  began  again  to 
look  a  little  red.  On  the  twenty-ninth,  the  inflammation  increased,  and  there  was  a 
little  matter  formed.  On  the  thirtieth  he  was  seized  with  fever.  The  small-pox  ap¬ 
peared  at  the  regular  time,  went  through  its  usual  course  and  terminated  favorably.” 
fVol.  3,  Treatise  on  the  Blood,  Inflammation  and  Gunshot  Wounds — pp.  3-5. 

“ All  diseased  actions  are  simple. — A  disposition  of  one  kind  may  and  shall  exist  in  a  part 
or  whole,  while  an  action  of  another  kind  is  going  on  ;  and  when  the  action  ceases,  the 
disposition,  or  dormant  action,  if  we  may  be  allowed  to  call  it  so,  shall  then  come  into 
action.  *  * 

“  Two  children  were  inoculated  for  the  small-pox.  Their  arms  inflamed,  but  about  the 
third  or  fourth  day  from  the  inoculation  symptoms  of  fever  arose,  and  the  measles  ap¬ 
peared,  and  went  through  their  progress  as  usual.  During  this  time  the  inflammation  in 
the  arm  was  arrested ;  but  when  the  measles  were  completely  gone,  the  small-pox  took 
place,  and  went  through  its  progress. 

“  Here  a  disposition  for  the  measles  had  taken  hold  of  the  body,  but  although  it  had 
done  that  previously  to  the  small-pox,  yet  it  was  not  in  such  a  way  as  stopped  the  pro¬ 
gress  of  the  small-pox.  The  small-pox  matter  was  capable  of  contaminating,  and  pro¬ 
duced  inflammation,  which  went  to  a  certain  length,  but  the  moment  the  measles  changed 
their  disposition  into  action,  as  the  two  actions  could  not  go  together,  the  action  of  the 
small-pox  was  suspended  till  the  measles  had  gone  through  its  action,  and  the  moment 
the  constitution  got  free  of  this,  the  small-pox  began  to  act  again. 

“A  lady  of  rank  was  inoculated  by  Mr.  Sutton.  A  few  days  after  a  fever  came  on,  of 
the  languid  or  putrid  kind,  but  without  any  eruption,  except  a  few  petechise  on  the 
breast ;  she  went  through  the  process  of  a  low  fever,  aud  afterwards  the  small-pox  com¬ 
menced  ;  yet  when  the  pustules  matured  they  spread  and  were  very  large;  also  a  differ-' 
ent  set  of  eruptions  succeeded  so  that  thirty  days  passed  before  the  skin  was  clear  of  the 
eruptions. 


Spurious  Vaccination :  Joseph  Jones,  M.  D. 


297 


“  These  cases  show  that  hut  one  mode  of  action  can  take  place  at  the  same  time ;  yet 
I  could  conceive  that  two  actions  might  produce  a  third  one,  which  might  have  been  a 
new  poison,  as  the  last  case  in  some  measure  seems  to  show.”  ( Vol .  1,  Principles  of  Sur¬ 
gery,  pp.  312-313.) 

Dr.  Joseph  Adams,  in  his  valuable  Observations  on  Morbid  Poisons, 
Chronic  and  Acute  (London,  2d  Ed.,  1807,),  advocated  the  doctrine  of 
Hunter,  that  u  Two  actions  cannot  be  carried  on  at  the  same  time,  or  in  the 
same  constitution.  And  recorded  in  his  work  the  following  observations  to 
sustain  this  proposition : 

“Though  the  law  was  entirely  overlooked  till  Mr.  Hunter’s  time,  yet  it  is  now  as  well 
ascertained  as  any  other  in  pathology.  It  is  worth  remarking,  that  in  all  the  epidemics 
described  by  Sydenham,  in  which  small-pox  and  measles  raged  at  the  same  season,  he 
gives  no  bint  of  there  ever  appearing  at  the  same  time  in  the  same  person  Dierembroek, 
indeed,  mentions  a  solitary  instance  in  which  the  two  diseases  took  place  at  the  same 
time.  His  son  remarks  on  the  passage,  that  he  never  met  with  a  similar  instance  more 
than  twice  in  his  own  practice.  Dierembroek’s  account  is  somewhat  confused.  It  should 
be  remarked,  too,  that  measles  was  at  that  period  not  so  distinctly  marked  as  in  later 
times,  and  that  with  the  small-pox  and  other  exanthemata,  an  unusual  efflorescence, 
which  may  be  mistaken  for  measles  is  not  uncommon  We  have,  however,  two  cases 
given  us  by  that  close  observer,  Dr.  Russell  ( Medical  and  Chirurgical  Transactions ,  vol.  2, 
p.  90),  which  from  the  reputation  of  the  author,  deserves  particular  notice.  The  series 
and  order  of  symptoms  are  traced  with  such  accuracy,  as  not  only  to  place  the  fact  be¬ 
yond  a  doubt,  but  to  enable  us  to  make  remarks  without  conjectures,  or  with  only’ such 
as  every  reader  will  see  are  admissible. 

“  We  shall  first  observe,  that  when  in  the  ill-built  and  crowded  city  of  Aleppo,  small¬ 
pox  and  measles  were  at  the  same  time  epidemic  for  three  months  together,  only  two 
such  cases  occurred.  In  both  these  cases,  the  measles  were  of  a  formidable  kind.  It  is 
now  established,  that  if  measles  do  not  produce  their  full  action,  they  sometimes  occur  a 
second  time.  {See  Dr.  Willan’s  Diseases  of  London,  p.  207. )  It  would  be  a  curious  inquiry, 
if  there  were  chance  that  it  could  be  satisfied,  to  learn  whether,  on  a  future  epidemic, 
these  children  took  the  measles  again.  However,  those  who  know  how  few  laws  in 
pathology  are  without  any  exception,  will  only  be  surprised  that  this  should  so  rarely 
occur. 

“  Dr.  Settsom  (Mem.  of  Med.  Society,  vol.  4,  p.  288),  relates  the  history  of  a  family, 
consisting  of  the  parents,  eight  children,  and  three  servants,  among  whom  scarlatina 
and  measles  appeared  about  the  same  time.  Some  had  measles  first,  others  scarlatina. 
All  the  latter,  and  as  many  as  had  gone  through  them  before,  had  measles.  In  conse¬ 
quence  of  this  succession,  adds  the  Doctor,  the  disease  continued  in  the  family  for  two 
months,  which  probably  might  have  terminated  in  as  many  weeks;  but  no  person  had 
the  two  diseases  at  the  same  time,  so  far,  at  least,  as  could  be  ascertained  by  the  symp¬ 
toms  !” 

The  industrious  De  Haen,  wishing  to  discover  a  common  original  cause  for  all  the 
exanthemata  remarks  that  small-pox  and  measles  usually  become  epidemic  about  the 
same  time.  Referring  to  his  notes,  he  observes,  that  in  the  year  1752,  scarce  a  family  but 
was  visited  by  other  diseases  at  the  same  time,  yet  each  individual  had  the  two  diseases 
in  succession — Videas  successive  iisdem  in  aedibus  occupare  infantes  quorum  alii  mor- 
billis,  variolis  alii  laborere  demum  iticipiaut. — Pat.  Med.,  vol.  i.,  page  102. 

“Dr.  Winterbottom,  in  a  general  vaccination,  describes  the  retardation  of  that  process, 
by  the  occurrence  of  measles,  as  an  event  too  common  to  excite  any  particular  attention. 
{Med.  Trans.,  vol.  xiv.,  p.  25).  The  same  retardation  was  remarked  by  Dr.  King,  from  the 
same  cause.  {Med.  Trans.,  vol.  xiii. ,  p.  167).  The  same  occurred  to  Mr.  Wachsell,  at  a 
general  inoculation  in  Walthamstow. 

“Dr.  Willan  observes,  that  it  is  generally  found  the  small-pox,  measles,  scarlet  fever, 
and  whooping-cough,  become  epidemic  about  the  same  time,  and  continue  their  progress, 
though  not  with  equal  violence.  {Diseases  of  London p.  105).  Yet  of  the  three  former  he 
gives  no  instance  in  which  two  of  them  appeared  at  the  same  time  in  the  same  person. 
It  is  evident  that  this  was  not  from  any  inadvertency,  because  we  find  the  same  accurate 
writer,  on  another  occasion,  observing  that  whooping-cough  and  small-pox  had  occa¬ 
sionally  occurred  in  the  same  person  and  at  the  same  time.  On  this  I  wrould  remark, 
that  -after  the  febrile  paroxysm  of  whooping  cough  has  subsided,  the  disease  loses  its 
specific  character,  and  if  the  lungs  have  materially  suffered,  the  cough  may  be  exas¬ 
perated  by  the  variolous  paroxysm.  But  Dr.  Willan,  in  another  place  {Diseases  of  London, 
pp.  38-39)  asserts,  that  in  some  instances  whooping  cough  commenced  during  the  small¬ 
pox  eruption.  If  this  fact  had  been  furnished  by  a  less  accurate  observer,  I  would  have 
objected,  that  whenever  whooping  cough  is  epidemic,  we  have  usually  other  severe  coughs 
at  the  same  time,  which  in  children,  are  not  easily  distinguishable  from  whooping  cough. 
But  admitting  the  accuracy  of  the  statement,  it  only  proves,  as  Dr.  Willan  observes, 


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that  the  law,  though  very  general,  is  not  without  any  exception.  We  have  also  his  own 
authority,  that  in  some  instances  the  whooping  cough  was  instantly  superceded  by  small¬ 
pox,  and  after  the  decline  of  the  latter,  returned  with  the  same  violence  as  before.  Mr. 
Oakes  ( Medical  Journal,  vol.  8.,  p.  426)  relates  the  case  of  a  child  whom  he  was  under 
the  necessity  of  inoculating  with  small-pox  whilst  under  the  whooping  cough.  The  con¬ 
sequence  was  that  as  soon  as  the  eruption  appeared,  the  cough  ceased  and  never  re¬ 
turned.  The  same  has  frequently  happened  after  vaccination,  and  I  have  reason  to  be¬ 
lieve,  permanently,  as  the  cough  has  not  returned  ar  least  ten  days  after  the  process  of 
vaccination  has  been  completed.  This  is  now  so  generally  understood,  that  many 
mothers  have  brought  their  children  to  the  hospital  for  vaccination,  under  an  expecta¬ 
tion  of  curing  them  of  whooping  cough,  and  I  do  not  recollect  that  any  of  them  have 
been  disappointed.  However,  I  would  never  recommend  it  till  the  acute  symptoms  of 
the  cough  are  passed,  for,  as  till  that  time  the  full  action  of  the  disease  is  not  over,  it  is 
reasonabfe  to  expect  its  return  when  the  process  of  vaccination  is  completed. 

“To  those  who  are  fond  of  tracing  the  operation  of  nature  under  disease,  it  will  be 
curious  to  mark  the  exact  regularity  of  the  succession  of  these  morbid  poisons  when  they 
occur  in  the  same  subject.  Mr.  Hunter,  (Introduction  to  Treatise  on  the  Venereal 
Disease,  and  also  to  the  Treatise  on  the  Blood,  etc).,  found  the  variolous  insertion  in  his 
patient  interrupted  on  the  fourth  day  after  the  puncture  was  made,  till  which  time  it  had 
proceeded  regularly.  On  the  day  following,  themorbillous  fever  commenced,  and  on  the 
fourth  day  after  that,  the  measles  appeared.  Four  days  afterwards,  the  measles  began  to 
disappear.  During  these  eight  days,  the  variolous  insertion  had  made  no  progress;  but 
on  the  following  day  it  recommenced  its  process,  and  in  five  days  afterwards  the  variolous 
fever  commenced.  Here  the  constitutional  disposition  was  interrupted  on  the  fourth  day. 
On  its  recommencement,  five  days  more  were  necessary  before  the  action  could  take  place, 
nine  days  being  the  medium  between  the  insertion  of  small-pox  and  the  commencement 
of  the  variolous  fever. 

“Mr.  Cruickshank’s  case  (Treatise  on  the  Absorbent  Vessels,  p.  126,)  appears  to  have 
been  interrupted  ab  initio  :  for  he  found  his  patient  with  all  the  symptoms  of  morbillous 
fever  on  the  ninth  day  after  inoculation.  The  punctures  of  the  arms,  therefore,  con¬ 
tinued  invisible  till  the  constitution  began  to  recover  from  the  measles,  after  which  time 
the  punctures  inflamed  and  required  their  full  period  of  eight  days  for  the  appearance  of 
small  pox. 

“  In  a  general  vaccination  at  Walthamstow,  two  children  were  seized  with  the  morbil¬ 
lous  eruption  on  the  eighth  day  after  vaccination.  In  these  the  areola  from  that  virus 
was  suspended  for  four  days.  In  a  third,  on  the  tenth  day  ;  and  here  the  interruption  to 
the  process  was  only  three  days. 

“But  a  most  elegant  experiment,  in  illustration  of  this  subject,  is  contained  in  Dr. 
Willan’s  last  number  of  Cutaneors  Diseases.  ‘I  inoculated,’  says  Dr.  Willan,  ‘about 
the  same  time,  three  children  with  the  fluid  contained  in  these  (lymphatic  or  miliary 
vesicles  in  measles),  but  no  effect  was  produced  by  the  iuoculation.  A  similar  trial,  at 
the  inoculation  hospital,  proved  more  successful.  Richard  Brooks,  aged  eighteen,  was 
inoculated  by  Mr.  Waschsei  with  fluid  from  the  miliary  vesicles  in  the  measles,  and  with 
vaccine  virus,  January  6,  1800.  On  the  tenth  there  was  some  redness  and  ulceration  in 
both  the  inoculated  places.  January  15,  the  redness  round  the  part  where  the  lymph  of  - 
the  measles  was  inserted  had  disappeared,  while  the  vaccine  pock  was  vivid.  January 
18,  the  vaccine  disease  was  over.  January  22,  he  has  a  severe  cough,  sneezing  and 
watery  eyes,  with  cold  shiveriugs  and  fainting.  January  28,  the  measles  appeared ;  his 
eyes  were  iuflamed  and  the  lids  swollen.  January  29,  the  efflorescence  was  diffused  all 
over  the  surface  of  the  body;  frequent  cough  and  violent  fever.  February  1,  efflores¬ 
cence  disappeared  ;  cough  and  fever  much  abated.  From  that  time  he  gradually  recov¬ 
ered,  and  was  dismissed  in  health  on  the  twelfth  of  February.’ 

“This  interesting  passage,  besides  containing  an  account  of  the  successful  inoculation 
of  the  measles,  affords  also  a  striking  illustration  of  the  protraction  of  a  disease,  after  the 
disposition  of  it  had  taken  place,  and  its  regular  return  to  complete  all  its  periods,  as 
soon  as  the  cause  which  interrupted  them  ceased.  This  subject  was,  at  the  same  time, 
susceptible  of  the  two  contagions  ;  and  as  long  as  the  diseased  actions  were  local,  both 
went  on  at  the  same  time  in  different  parts.  But  as  soon  as  the  constitutional  disposi¬ 
tion  commenced  in  one  (the  vaccine),  the  local  action  from  the  other  was  suspended. 
When  the  vaccine  disposition  and  action  were  completed,  the  rubeolous  disposition  com¬ 
menced.  Four  days  afterwards  the  constitutional  symptoms  showed  themselves,  with 
cough,  sneezing  and  watery  eyes.”  In  six  days  more  the  eruptive  symptoms  began,  and 
were  completed  on  the  following  day.  On  the  fourth  day  afterwards,  the  efflorescence 
disappeared  and  the  symptoms  abated,  making,  in  the  whole,  about  twenty-seven  days, 
a  fair  allowance  for  the  two  diseases. 


+Dr.  Willan  considers  the  common  period,  after  infection  by  effluvia,  before  these  symptoms  appear  to  be 
from  six  to  ten  days.  The  anticipation  in  this  case,  by  inoculation,  is  nearly  analogous  to  the  mean  differ¬ 
ence  between  inoculated  and  casual  small-pox . 


Spurious  Vaccination:  Joseph  Jones,  M.  D. 


299 


“  The  following  laws,  then,  are  to  be  admitted,  with  as  few  exceptions  as  any  others 
that  are  received  in  pathology  : 

“  1.  All  persons  are  susceptible  of  the  impression  from  a  morbid  poison,  in  proportion 
as  they  are  unaccustomed  to  it. 

“2.  That  susceptibility  aud  disposition  are  necessary  in  a  constitution  or  part  before  the 
action  excited  by  a  morbid  poison  can  take  place. 

“3.  That  after  the  constitutional  disposition  has  taken  place  from  a  local  diseased 
action,  the  destruction  of  that  local  action  will  prevent  the  future  appearance  of  the 
constitutional  disease. 

“  4.  That  no  two  actions  from  two  different  morbid  poisons  can  be  carried  on  at  the 
same  time  in  the  same  part,  or  in  the  same  constitution. 

“5,  If  a  constitutional  disposition  to  one  morbid  poison  exists,  whilst  the  action  of 
another  is  going  on  in  the  constitution,  we  ought  to  expect  the  action  of  the  first  to  ap¬ 
pear  after  the  action  of  the  second  is  completed,  or  has  ceased. 

“  6.  Though  nothing  can  prevent  an  action  from  following  after  a  disposition  has  taken 
place,  yet  a  disposition  may  be  prevented  by  preventing  a  susceptibility  in  the  constitu¬ 
tion  or  part. 

“7.  The  susceptibility  may  be  prevented  by  rendering  the  constitution  familiar  with 
the  morbid  poison,  or.  as  long  as  the  constitution  is  exposed  to  it,  by  keeping  up  a  con¬ 
stitutional  action  previously  excited  by  another  morbid  poison,  or  any  other  cause.” — 
Adams  on  Morbid  Poisons ,  pp.  21-23. 

Dr.  Limdford,  a  native  of  Jamaica,  who  made  Yaws  the  subject  of  his 
inaugural  dissertation,  states  that  “  those  who  are  under  the  Yaws  are 
liable  to  the  other  exanthemata,  such  as  measles  and  small-pox.  The  lat¬ 
ter  may  be  iuduced  by  exposure  or  inoculation,  which  last  is  better 
attempted  when  yaws  is  in  the  decline,  for  then  the  small-pox  will  either 
entirely  take  away  yaws,  or  at  least  will  check  it  for  some  time;  nor  will 
the  funguses  continue  long,  even  if  they  should  happen  to  appear  again  on 
the  surface.” 

Upon  this  observation  Mr.  Adams,  in  his  work  on  Morbid  Poisons, 
remarks : 

“  All  this  is  perfectl>  analogous  to  wbat  has  been  traced  in  other  morbid  poisons.  It 
is  probable  that  the  irritation  from  small-pox  and  measles,  being  greater  than  from  yaws, 
may  interrupt  the- latter  at  any  time.  But  the  laws  of  that  poison,  requiring  a  certain 
course  to  be  pursued,  if  the  new  irritation  is  induced  before  that  course  is  completed, 
the  disease  must,  return  as  that  new  irritation  ceases.  If,  on  the  contrary,  the  irritation 
has  not  been  induced  till  the  course  of  yaws  is  completed,  and  nothing  remains  of  it  but 
an  habitual  ulceration,  the  new  irritation  will  not  only  supercede  the  old  action,  but  by 
breaking  the  habit  very  much  expedite  the  cure.” 

“  Dr.  Dancer,  in  confirmation  of  the  above,  gives  the  following  quotation  lrom  Dr. 
Membhard  :  ‘  During  the  universal  prevalence  of  small-pox  in  this  Island,  in  the  year 

1784,  it  was  remarked,  that  several  negroes  afflicted  with  yaws,  who  had  the  yawy  pus¬ 
tules  omthe  surface  of  the  body,  and  had  been  a  considerable  time  under  all  the  afflicting 
circumstances  of  the  disease,  were  inoculated  promiscuously  among  many  other  negroes. 
The  result  was  that  upon  the  decline  of  small-pox,  and  dying  away  of  the  pustules,  the 
yaws  also  gradually  disappeared ;  as  if  both  might  be  considered  in  the  light  of  one 
congenial  disease.  ( Adams  on  Morbid  Poisons,  pp.  212-213.) 

Dr.  Delgrade  relates  several  cases  of  the  simultaneous-  occurrence  of 
small-pox  and  measles,  which  ran  their  course  together.  A  child  was  in¬ 
oculated  with  the  matter;  on  the  eighth  day,  this  infant,  after  a  slight  indis¬ 
position,  took  the  measles. 

“  On  the  fifteenth,  after  having  completely  recovered  from  themeasles  she  became  very 
feverish.  Between  this  and  the  twentieth,  she  had  several  convulsions.  On  that  day 
small-pox  appeared.  The  infant  not  having  been  near  any  other  child  with  that  disorder, 
it  was  thus  proved  not  only  that  the  eruption  was  variolous,  but  that  the  fever  was  in¬ 
fections. 

“Still  the  difficulty  remained  of  accounting  for  its  origin,  since  no  small-pox  was 
known  to  prevail  in  the  neighborhood.  The  parents  and  neighbors  could  give  no  clue. 
Soon  afterwards  I  heard  that  a  child  had  recently  died  of  combined  small-pox  and 
measles  Unable  to  trace  this  report,  I  concluded  it  was  merely  an  erroneous  account  of 
the  present  case.  Calling,  however,  with  Mr.  Daniel!,  on  a  female,  one  of  his  dispensary 
patients,  she  informed  me  that  the  child  was  her  own.  Of  this  case  I  can  give  no  accu¬ 
rate  narrative.  The  mother  herself  was  dying,  and  the  child  had  been  visited  by  no 
medical  attendant.  Judging  from  the  statement,  I  imagine  the  two  diboiders  occutrtd 


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in  succession,  not  simultaneously.  The  child  was  taken  ill  some  days  before  Brookes’  and 
certainly  died  of  small-pox.  Yet  even  this  was  unsatisfactory  since  the  families 
lived  at  a  distance  from  each  other.  No  communication  of  the  children  was  known,  un¬ 
til  I  discovered  they  had  attended  the  same  school,  a  circumstance  of  which  their  friends 
were  mutually  unconscious.”  ( Medical  Chirurgical  Transcript,  of  London,  vol.  1,  Part  I.) 

Dr.  Russell,  in  noticing  the  reciprocal  influence  of  small-pox  and  measles, 
states  that  he  carefully  watched  above  three  hundred  cases  in  which  these 
diseases  succeeded  each  other,  at  a  time  when  they  were  both  epidemic  at 
Aleppo  (1765).  He  noticed  that  the  measles  rarely  succeeded  small -pox  in 
less  than  twenty  days  from  the  first  appearance  of  the  eruption.  Several 
cases  occurred  where  small-pox  succeeded  measles  before  the  total  disap¬ 
pearance  of  rubeolous  rash  from  the  extremities,  that  is  on  the  eleventh  or 
twelfth  day  of  the  eruption.  He  adds,  “  so  little  did  the  quality  of  the 
first  disease  influence  that  of  the  second,  that  a  mild,  distinct  small-pox 
was  often  observed  to  follow  the  worst  kind  of  measles,  and  vice  versa.” 
Willan  relates  the  case  of  a  young  man,  aged  eighteen,  inoculated  for 
measles  and  cow-pox  on  the  same  day ;  the  cow-pox  took  the  lead,  measles 
following  at  the  end  of  sixteen  days  j  and  Dr.  Gregory  has  described  a  case 
very  analogous,  but  there  measles  had  the  start,  and  after  sixteen  days 
cow-pox  had  its  turn.  Dr.  Gregory  calls  attention  to  the  fact,  that  in  each 
case  sixteen  days  was  the  period  of  suspension,  and  expresses  his  belief 
that  this  was  not  accidental.  (Lectures  on  the  Eruptive  Fevers. ) 

Dr.  Moreland  reported  to  the  Boston  Society  for  Medical  Improvement 
the  following  interesting  case : 

On  the  thirteenth  of  February,  1856,  he  vaccinated  a  healthy  male  infant, 
six  months  old.  On  the  seventeenth  of  the  same  month,  a  faint  but  suffic¬ 
iently  distinct  eruption  of  measles  was  observed  about  the  neck  and  shoul¬ 
ders.  The  usual  symptoms  of  rubeola  had  declared  themselves  on  the  next 
morning  after  the  vaccination,  and  the  disease,  consequently,  must  have 
commenced  only  a  few  hours  previously  to  that  operation,  if  four  days  be 
adopted  as  the  period  elapsing  between  the  attack  and  the  *  appearance  of 
the  eruption.  The  vaccine  vesicle  matured  very  slowly  for  several  days, 
and  the  rubeolous  eruption  continued  with  varying  distinctness,  but  al¬ 
ways  comparatively  slight,  until  the  nineteenth  of  February,  when  it  dis¬ 
appeared.  The  vaccine  vesicle  then  took  a  start,  and  went  on  rapidly  to 
perfection.  There  seemed  to  be  a  retarding  action  reciprocally  maintained 
for  a  time  by  the  two  affections,  thus  accidentally  concurrent ;  vaccine 
finally  prevailing.  The  circumstantial  record  made  at  the  time  reads  thus : 

“  February  17,  vaccinat  ion  apparently  taking  effect,  measles  appeared  ;  will  the  vesicles 
be  retarded  ?  18,  vesicles  advancing  very  slowly,  measels  retrograding ;  ordered  a  warm 

bath.  19,  vesicles  going  on,  but  more  slowly  than  is  common;  less  redness  around  it; 
eruption  of  measles  gone  ;  will  it  recur  ?  20th,  vacciue  vesicle  much  larger  ;  child  fever¬ 
ish  ;  warm  bath.  21,  at  7:15  o’clock  in  the  morning,  the,  child  was  seized  with  a  severe 
general  convulsion.  He  was  seen  by  Dr.  M.  in  about  twenty  minutes  ;  a  warm  bath  had 
been  used.  Wine  of  ipecac,  and  enemata,  with  cold  lotions  to  the  head,  were  at  once 
resorted  to,  and  subsequently,  three  grains  of  calomel  with  five  of  rhubarb  were  given. 
Aspect  of  the  little  patient  pale  t  and  confused.  At  1:45  o’clock  p.  m.,  he  had  another 
convulsive  attack  of  rather  greater  severity.  By  previous  direction,  he  was  immediately 
placed  in  a  warm  bath,  the  body  and  limbs  were  well  rubbed  with  the  hands,  and  sinap¬ 
isms  were  applied  to  the  abdomen  and  to  the  feet ;  the  face  being  colored  and  the  scalp 
showing  many  turgid  vessels,  a  large  leech  was  applied  to  the  left  temple,  and  the  wound 
was  allowed  to  bleed  for  half  an  hour  after  the  animal  fell  off.  No  more  convulsions 
through  the  day.  At  7:30  o’clock  p.  m.,  mustard  was  applied  to,  the  back  of  the  neck. 
The  night  of  the  twenty-lirst  was  passed  by  the  patient  in  quiet  sleep.  25,  very  bright 
and  well  to  all  appearance,  until  about  9:30  o’clock,  a.  m.,  when  he  had  another  very 
severe  convulsion,  lasting  several  minutes  longer  than  the  two  previous  ones.  He  was 
seen  fifteen  minutes  after  the  access  of  the  fit ;  was  found  stupid,  with  an  occasional 
wild  look  in  the  eyes  ;  had  been  placed  again  in  the  warm  bath.  Mustard-water  frictions 
to  the  extremities  were  continued;  the  head  being  rather  hot,  cold  applications  were 
cautiously  made  to  it ;  one  drachm  of  castor  oil  was  given;  discontinued  the  breast  milk. 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


301 


Dr.  Storer  saw  the  patient  at  this  time,  and  recommended  Dovers  powder,  one  eight  of 
a  grain  of  the  former  to  one  half  of  a  grain  of  the  latter,  every  three  hours  A  contin¬ 
uance  of  the  mustard-water  frictions  were  also  advised.  Dr.  S.  believed  that  another 
leech  might  he  needed.  Dr.  James  Jackson,  who  had  been  sent  for  at  Dr.  M.’s  request, 
visited  the  child  shortly  after,  and  gave  a  favorable  proguosis.  It  was  thought  best  by 
him  to  restrict  the  child’s  nursing  to  one  minute’s  time  every  two  hours  ;  and,  in  the  inter¬ 
vals,  to  allow  sugar  and  water.  Dr.  J.  thought  that  although  another  leech  might  pos¬ 
sibly,  be  required,  he  should  be  ‘  slow  to  apply  it.’  The  remainder  of  the  management 
was  concurred  in.  The  powders  above  mentioned  were  commenced,  and  the  other  means 
continued.  There  seemed  a  degree  of* amendment  in  the  afternoon  of  this  day,  and  there 
had  been  some  good  sleep.  The  night  of  the  twenty-second  was  quietly  passed  ;  there 
was  only  one  dejection  ;  a  little  colicky  pain  from  flatulence;  no  convulsive  action.  23, 
Quite  well,  seemingly;  pulse  118,  rather  sharp  (yesterday,  128  to  130);  skin  moist;  one 
powder  was  taken  at  bedtime  last  evening,  aud  another  this  morning.  The  vesicle  of 
vacciuation  has  broken  and  dried  into  quite  a  large  scab  ;  it  was  full,  yesterday.  In  the 
afternoou  of  this  day  the  child  seemed  dull  and  stupid,  possibly  from  fatigue  ;  the  lips 
and  tongue  somewhat  swollen  ;  suspended  the  regular  use  of  the  powders  ;  renewed  the 
mustard  frictions,  etc.  He  was  now  allowed  to  draw  the  breast  during  three  minutes, 
not  having  nursed  for  three  hours  previously.  Flatulence  troublesome  ;  relieved  by 
mint-water.  24,  night  quiet ;  had  one  dejection  ;  got  one  powder  about  midnight  ;  the 
eyes  somewhat  red  ;  no  signs  of  returning  rubeolous  eruptiou  ;  tougue  white;  occasional 
colic.  25,  nearly  as  well  as  ever.  26,  same  record.  27,  a  cervical  gland,  on  the  left 
side  (that  of  vaccination),  much  enlarged  ;  otherwise  very  well  and  lively.  Discontinued 
visits.  From  the  last  date  to  the  present  time,  there  has  been  no  untoward  occurrence, 
the  child  seeming  better  even  than  before  its  illness. 

“The  supervention  of  measles  upon  vaccination,  by  the  doctrine  of  chances,  must  he  rare  ; 
a  purely  accidental  occurrence.  The  points  of  interest  in  this  case  are  the  evident  mu¬ 
tually  retarding  influence  of  the  two  affections  thus  coexisting  ;  the  modification  of  the 
vaccine  vesicle  and  of  the  eruption  of  rubeola  by  this  action — not  uncommonly  witnessed 
under  such,  or  similar,  circumstances  of  complication — and,  especially,  the  convulsions, 
as  to  their  cause.  Dr.  M.  was  at  first  inclined  to  ascribe  these  to  the  retrocession  of  the 
measles;  but  it  will  be  noted  that  they  were  manifested  upon  the  eighth  day  after  vac¬ 
cination,  when  the  vesicle  should  be  perfect  and  the  primary  febrile  action  is  usually  ob¬ 
served — aud  consequently  they  may  be  more  reasonably  referred  to  the  latter.  This  was 
Dr.  Jackson’s  opinion.  How  much  influence  the  conjunction  of  the  two  affections  may 
have  had,  however,  can  hardly  be  determined.  Iu  his  recently-published  volume,  Dr. 
Jackson  gives  an  instance  where  convulsions  took  place  in  a  child  on  the  eighth  day 
after,  vacciuation.  Some  time  previous  to  this  the  patient  had  had  pneumonia,  which 
was  ushbred  in  by  convulsions,  and  the  same  had  occurred,  also,  during  dentition.  Dr 
J.  had  apprehended  they  might  take  place  after  the  vaccination,  and  had  forewarned 
the  mother  on  the  subject.  He  refers  to  other  cases  in  which  convulsions  were  observed 
in  children  at  the  commencement  of  bronchitis  and  scarlatina,  but  mentions  only  one 
after  vaccination.  Iu  the  case  detailed  abo^e,  tbere  had  not  been  any  convulsions,  pre¬ 
viously,  nor  any  threatening  of  them  ;  there  was,  therefore,  no  reason  to  expect  them. 

“In  this  connection,  the  remark  of  Sydenham  may  appropriately  be  referred  to  ‘that 
an  epileptic  fit,  in  infants,  is  so  sure  a  sign  of  small-pox,  that  if,  after  teething,  they 
have  one, -you  may  predict  variola — so  much  so  that  a  fit  over  night  will  he  followed  by 
the  eruptiou  next  morning.  This,  however,  will  be  generally  mild,  aud  in  no  wise  con¬ 
fluent.’  (Works,  Syd.,  Soc.  edit.,  v.  2,  p.  252.)  Dr.  Jackson  also  remai’ked  ‘that  he  be¬ 
lieved  convulsions  are  not  rare  in  children,  when  the  symptoms,  so-called,  of  small-pox, 
first  appear— corresponding  to  the  eighth  day  of  vaccination.’  It  would  seem  that  the 
accident  must  be  frequent  after  simple  vaccination.” — Boston  Medical  and  Surgical  Journal, 
June  19,  1856. 

Joler  has  described  an  epidemic  of  measles  that  took  place  in  the  Eetzat 
Circle,  in  Bavaria,  in  the  district  where  he  himself  resided.  He  says  that 
the  disease  was  much  milder  among  the  vaccinated  than  among  the  unvac¬ 
cinated.  Fifteen  in  fifty-two  died  among  the  non- vaccinated,  while  barely 
one  in  three  hundred  died  among  the  vaccinated,  showing  that  measles 
was  eighty-six  times  more  fatal  amdng  the  former  than  the  latter. 

As  far  as  our  knowledge  extends,  there  are  but  few  facts  bearing  upon 
the  question  of  the  possibility  of  the  transmission  of  the  poison  of  measles 
along  with  the  vaccine  virus. 

The  experiments  of  several  authors  have  shown  that  measles  may  be 
transmitted  by  inoculating  a  sound  person,  either  with  the  blood,  with  the 
fluid  of  the  accidental  vesicles  which  sometimes  complicate  the  eruption, 
or  with  the  secretion?  of  those  affected  with  the  disease. 


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Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


Dr.  Home,  of  Edinburgh,  in  1758,  appears  to  have  been  the  first  Euro¬ 
pean  physician  who  proposed  and  performed  the  inoculation  of  measles. 
His  method  of  inoculation  was  to  apply  cotton  dipped  in  the  blood  of  a 
measly  patient  to  a  wound  in  the  arm  of  the  well  patient.  He  describes 
the  febrile  symptoms  as  appearing  on  the  sixth  day,  and  of  a  mild  char¬ 
acter,  with  no  secondary  complications.  (Clinical  Facts  and  Experiments, 
1858.) 

Mr.  Wachsel,  of  the  Small-pox  Hospital,  in  the  early  part  of  this  cen¬ 
tury,  inoculated  successfully  a  lad  with  fluid  taken  from  the  measly  vesi¬ 
cles.  In  1822,  Dr.  Speranza,  an  Italian  physician,  in  the  territory  of  Man¬ 
tua,  repeated  the  experiments  of  Dr.  Home,  Professor  of  Meteria  Medica 
in  the  University  of  Edinburgh.  He  inoculated  six  cases  and  afterwards 
himself,  with  the  blood  taken  from  a  slight  scratch  in.  a  vivid  papula.  In 
a  few  days  the  measles  appeared,  and  went  through  their  course  mildly 
and  regularly.  This  encouraged  him  to  make  further  experiments,  and  he 
says  they  were  all  successful. 

Dr.  Yon  Katona,  ot  Borsoder,  in  Hungary,  conducted  an  extensive  series 
of  experiments  upon  the  inoculation  of  measles  in  1842.  He  inoculated 
1,122  persons,  by  taking  the  blood  and  fluid  from  the  vesicles,  or  a  drop  of 
the  tears  from  a  patient  laboring  with  the-  disease.  The  operation  is  said 
to  have  been  performed  in  the  same  manner  as  the  inoculation  for  small¬ 
pox  ;  the  infecting  blood  was  drawn  from  the  vesicles  most  effloresced. 
The  puncture  was  immediately  surrounded  1>3T  a  red  areola,  which  soon  dis¬ 
appeared.  On  the  seventh  day  the  fever  set  in  with  the  usual  premonitory 
symptoms  of  measles,  as  rigors  and  catarrhal  symptoms;  on  the  ninth 
and  tenth  day  the  eruption  appeared ;  on  the  fourteenth  desquamation 
commenced  with  decrease  of  fever  and  eruption  ;  and  on  the  seventeenth 
day  from  inoculation  (seventh  and  sometimes  eighth  from  eruption)  the 
patients  wrere  in  general  convalescent  and  apparently  well.  Dr.  Katona 
failed  only  in  seventy-eight  cases  out  of  1.112  (seven  per  cent.) ;  and  he 
affirmed  that  the  resulting  disorder  was  mild,  contrasting  favorably  with 
the  severity  of  the  reigning  epidemic.  No  deaths  occurred  among  the  in¬ 
oculated.  The  fruitless  and  un satisfactory  experiments  which  have  been 
performed  at  different  periods  for  the  purpose  of  testing  the  possibility  of 
inoculating  measles,  cannot  be  adduced  as  evidence  against  these  well- 
established  facts,  for  a  single  successful  inoculation  is  sufficient  to  over¬ 
throw  any  number  of  unsuccessful  attempts. 

Dr.  George  Gregory,  in  his  valuable  Lectures  on  the  Eruptive  Fevers ,  even 
goes  so  far  as  to  express  his  belief  that  the  child  whose  case  he  had  de¬ 
tailed  as  having  undergone  cow-pox  after  measles,  “  received  the  germ  of 
measles  and  of  cow-pox  at  the  same  time ;  in  other  words,  that  unknown 
to  me  the  child  that  furnished  the  lymph  was  incubating  the  measles,  with 
the  zuma  or  poison  of  which  the  vaccine  matter  had  been  impregnated.” 

The  following  is  the  case  as  recorded  by  Dr.  Gregory  : 

Eliza  Finch,  aged  four  months,  residing  at  Pentonville,  was  vaccinated 
by  me  at  the  Small-Pox  Hospital,  May  15,  1835.  May  17  the  child  began 
to  droop.  Bilious  vomiting,  very  severe,  with  drowsiness,  succeeded. 
Much  blood  passed  by  stool.  The  head*was  very  hot.  Vomiting  continued 
all  that  and  the  four  following  days.  It  ceased  on  the  twenty-second.  On 
the  twenty-fourth  the  other  febrile  symptoms  yielded  a  little.  On  the 
twenty-fifth  (nine  days  from  the  invasion  of  symptoms,  and  eleven  from 
the  probable  reception  of  the  germ,)  measles  appeared  and  went  through 
its  course  regularly. 

Whilst  the  preceding  facts,  in  the  main,  support  the  doctrine  of  Hunter, 
and  show  that  where  two  poisons,  representing  two  distinct  contagious  ex- 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


303 


anthematic  diseases,  act  simultaneously  upon  the  human  being,  the  most 
obvious  pathological  phenomena  excited  by  the  poisons  will  not  occur  sim¬ 
ultaneously,  but  in  succession,  the  one  poison  retarding  the  action  of  the 
other,  the  one  producing  its  cycle  of  changes,  whilst  the  other  remains 
dormant,  as  it  were,  during  the  action  of  the  other,  and  immediately  after 
the  changes  induced  by  the  first  cease,  inducing  its  own  distinct  effects  ; 
at  the  same  time  it  must  be  admitted  that  the  character  and  course  of  these 
specific  eruptive  diseases  are  greatly  modified  by  such  altered  states  of  the 
constitution  as  exist  in  scurvy,  scrofula  and  secondary  syphilis. 

In  that  class  of  diseases  represented  by  constitutional  syphilis  and 
scurvy,  the  whole  mass  of  blood  is  at  fault,  and  the  nutrition  is  perverted, 
and  the  course  and  products  of  diseased  actions  are  comparatively 
modified. 

A  s  all  the  nutritive  processes  are  more  or  less  deranged  iu  scurvy  and 
secondary  syphilis,  and  as  it  is  now  established  that  the  blood  in  the  latter 
disease  is  capable  of  reproducing  syphilis  when  inoculated  iu  healthy 
bodies,  and  as  we  have  shown  that  in  scurvy  the  blood  is  so  deteriorated 
and  the  forces  so  depressed,  that  the  smallest  injuries  tend  to  degenerate 
into  foul  gangrenous  ulcers,  it  is  but  reasonable  to  conclude,  apart  from 
well-established  facts,  that  the  vaccine  lymph  would  partake  of  the  quali¬ 
ties  and  properties  of  the  blood  from  which  it  is  formed,  and  the  parts  by 
which  it  is  secreted.  And  even  if  the  doctrine  be  maintained  that  the 
vaccine  matter,  as  well  as  all  other  special  morbid  poisons,  have  an  unvary¬ 
ing  chemical  and  physical  constitution,  the  difficulty  is  not  removed,  i\s  in 
the  practice  of  vaccination  we  are  unable  to  separate  the  active  agent  of 
the  virus,  from  much  extraneous  matter,  as  lymph  and  blood.  And  we 
contend  that  it  is  impossible  to  open  a  living  vaccine  vesicle  and  draw 
matter  for  vaccination,  without  injuring  to  a  greater  or  less  extent,  the 
delicate  blood-vessels,  within  and  around  the  vesicle. 

With  reference  to  the  concurrent  action  of  the  poisons  of  two  contagious 
exanthemata,  upon  the  same  system,  we  know  nothing  whatever  of  the 
state  and  mode  of  the  existence  of  that  poison  which  lies  dormant  whilst 
the  other  is  acting.  Does  it  remain  in  the  part  where  it  has  been  inserted, 
or  does  it  exist  as  well  in  the  blood,  and  effect  those  organs  and  tissues 
which  are  not  implicated  iu  the  action  of  the  first  ? 

Until  the  relations  and  effect  of  each  exanthematous  poison  has  been 
carefully  studied,  and  its  effects  determined  upon  the  constitution  of  the 
blood,  upon  the  process  of  nutrition,  upon  the  action  of  the  nervous  system, 
and  upon  the  chemical  and  physical  phenomena  of  the  body,  as  manifested 
more  especially  in  the  disturbances  of  circulation,  respiration  and  calorifi¬ 
cation,  and  excretion,  it  will  be  difficult  if  not  impossible  to  settle  such 
questions. 

RELATIONS  OF  CHICKEN-POX  TO  SMALL  POX— HISTORY  AND 
PHENOMENA  OF  CHICKEN-POX  ( VARICELLA)  —  DIFFER¬ 
ENTIAL  DIAGNOSIS  BETWEEN  VARICELLA  AND  VARIO¬ 
LOID. 

CHICKEN-POX  (VARICELLA)  CRYSTALLED  —  VARIOLA  SPURIA—  VARIOLA 
LYMPHATICA— VARICELLA  VOLATICA— VARIOLA  PUSILLA— EXANTHEMA 
VARICELLA. 

Definition. — An  eruption  over  the  body,  of  semi-transparent  glabrous  vesi¬ 
cles,  with  red  margins  accompanying  a  slight  attack  of  fever,  seldom  passing 
into  suppuration ;  but  on  the  third  day,  bursting  at  their  tips,  concreting 


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Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


into  small  puckered  scabs,  aud  leaving  no  cicatrices.  The  disease  consists 
of  a  specific  eruption,  in  a  series  of  new  crops  usually  appearing  for 
several  days  in  succession ;  so  that  dried  and  fresh  vesicles  are  often  along¬ 
side  of  each  other,  on  the  breast,  back,  face,  and  extremities,  preceded  by 
fever.  The  disease  may  be  portracted  for  a  fortnight  or  longer. 

Changes  of  Temperature. — According  to  Thomas  and  other  observers,* 
sometimes  in  the  incubation  stage  of  varicella ,  there  are  slight  elevations  of 
temperature,  and  at  the  time  of  the  eruption  in  many  cases  the  rise  of  tem¬ 
perature  is  very  trifling.  In  the  majority  of  cases,  however,  sometimes  at 
the  beginning  of  the  exanthematic  period  and  sometimes  after  a  copious 
eruption  had  been  developed,  there  is  a  sudden  and  relatively  considerable 
elevation  of  temperature,  sometimes  indeed  only  a  few  tenths  over  38°  c., 
or  about  101°  F. ;  in  rather  severe  cases  38.5°  c.  (101.5°  F.)  to  40°  c.  (104° 
F.);  but  seldom  more.  The  high  stage  lasts  from  two  to  five  days,  and 
the  fever  is  remittent,  aud  as  regards  the  height  of  the  temperature  cor¬ 
responds  pretty  accurately  witli  the  copiousness  of  the  eruption.  The 
maximum  temperature  occurs  sometimes  in  the  first,  but  more  often  in  the 
second  half  of  the  fastiginm,  and  the  morning  remissions  after  the  maxi¬ 
mum  were  somewhat  more  considerable  than  they  had  been  before.  De¬ 
fervescence  was  rapid  and  commonly  over  in  half  a  day. 

Under  the  name  of  chicken-pox,  or  varicella ,  have  generally  been  com¬ 
prised  certain  eruptions  which  closely  agree  in  many  features  with  each 
other,  and  which  in  some  respects  resemble  small-pox.  It  is  from  this  lat¬ 
ter  circumstance  that  they  deserve  a  particular  notice,  as  they  are  gener¬ 
ally  of  so  slight  a  nature  as  to  require  but  little  medical  treatment.  They 
were  formerly  very  generally  confounded  with  small  pox;  but  the  differ¬ 
ence  between  them  was  remarked  as  early  as  the  beginning  of  the  sixteenth 
century,  by  Vidus  Vidius  and  Ingrassis.  Sennery  and  Eiveri,  professors 
at  Wurtemburg  and  Montpellier,  at  the  commencement  of  the  seventeenth 
century,  and  Diemerbrock,  state  that  the  distinction  was  well  known  in 
Germany,  France  and  Italy,  to  the  vulgar,  who  had  a  separate  appellation 
for  this  eruption.  Morton  was  the  first  in  England  to  mark  the  differ¬ 
ence,  and  to  describe  this  disease  under  the  name  of  “  chicken-pox .”  Since 
then  it  has  been  noticed  by  Fuller,  and  accurately  described  by  Heberden. 
Heberden,  however,  continued  to  designate  it  by  the  term  variola  pusilla  ; 
whilst  his  cotemporaries,  Vogel,  Burserius  and  Sauvages,  also  applied  to  it 
the  generic  term,  variola ,  with  the  specific  designation  of  volatica ,  spuria 
and  lymphatica. 

Dr.  Heberden  must  be  regarded  as  the  principal  writer  on  varicella,  who, 
m  1767,  published  in  the  first  volume,  page  427,  of  the  Transactions  of  the 
Boyal  College  of  Physicians,  a  description  of  the  disease,  professing  to 
give  a  full  and  accurate  account,  not  only  of  its  symptoms,  but  of  its  pa 
thological  relations  ;  and  for  a  long  series  of  years  this  paper  was  looked 
upon  as  a  standard  authority  on  this  disease. 

In  1805,  Dr.  Frank,  of  Vienna,  carefully  distinguished  the  several  kinds 
of  spurious  small-pox,  and  by  way  of  distinction  applied  to  them  the 
names  of  pemphigus  varioloides ,  vesicularis  and  solidescens.  His  description 
of  the  former  disease  corresponds  accurately  with  the  complaint  hitherto 
called  chrystal-pock,  water-pock  and  chicken-pock. 

In  1809  a  detailed  account  of  varicella  was  published  by  Dr.  Heim,  of 
Berlin,  but  much  confusion  is  occasioned  by  his  applying  the  same  term  to 
designate  three  kinds  of  spurious  small-pox — the  water-pock,  the  horn- 


*  Archiv  der  Keilkunde,  8,  376  ;  Archiv  fur  Dermatologie  and  Syphilis,  1,  309.  Temperature  in  Diseases, 
Dr.  C.  A.  Wunderlich,  New  Sydenham  Society,,  1871,  p.  3ll. 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


305 


pock  and  the  swine-pock.  Dr.  Heim  affirmed  that  matter  taken  from  a 
subject  who  has  chicken-pox  will  only  produce  chicken-pox,  and  afford  no 
protection  from  small-pox.  He  also  states  that  the  cicatrices  left  by  vari¬ 
cella  were  different  from  those  of  variola,  and  that  a  careful  inspection  of 
them  is  alone  sufficient  to  designate  the  one  disorder  from  the  other. 

We  find,  upon  careful  examination,  a  similar  statement  as  to  the  inoc- 
ulability  of  chicken  pox,  in  u  The  Report  on  the  Cow-pox  Inoculation ,  from 
the  practice  at  the  Vaccine-Pock,  Institution,  during  the  years  1800,  1801  and 
1802,  read  at  the  general  meeting  of  the  Governors ,  February  7,  1803,  at  the 
Shakespeare  Tavern ;  written  by  the  Physician  of  the  Institution  ;  to  which  are 
affixed  two  painted,  engravings  of  coic-pox  and  other  eruptions .”  London,  1803 ; 
p.  41. 

The  following  is  the  detailed  statements  of  the  Physicians  of  the 
Cow-pox  Institution,  Drs.  George  Pearson,  Lawrence  Nilioll  and  Thomas 
Nelson  in  the  above  mentioned  report : 

Chicken-pox  occurring  during  vaccina,  at  any  period,  as  well 

AS  AFTER  THE  VACCINA. 

2.  Chicken-pox — Intervening  cases  have  occurred  of  chicken-pox  not 
only  at  all  times  Curing  the  cow-pock,  but  immediately  after  the  scabbing 
process ;  as  well  as  subsequently  at  a  much  later  period.  In  this  last  re¬ 
spect  of  the  chicken-pox  after  the  formation  of  the  scab,  or  at  a  later 
period  of  the  cow-pock,  there  is  a  difference  between  the  chicken-pox  and 
small- pox.  No  differences  was  observed  in  the  stages  of  the  cow-pock,  or 
of  the  chicken-pox,  when  the  two  diseases  went  on  together ;  except  that 
the  cow-pock  was  sometimes  a  little  retarded  in  scabbing. 

In  these  instances  there  may  be  a  constitutional  affection  for  each  of  the 
diseases  on  different  days,  or  they  may  occur  together. 

In  one  case,  the  chicken-pox  and  the  vaccine  pock  were  inoculated  on  the 
same  subject,  and  both  went  on  as  usually  distinctly.” 

Dr.  Willan,  in  1806,  advanced  somewhat  our  knowledge  of  varicella, 
by  some  observations  published  in  the  seventh  and  eighth  edition  of  his 
work,  (On  Vaccine  Inoculation,  qt.,  p.  86).  He  therein  describes  with  great 
minuteness,  the  appearance  of  varicellous  eruption,  which  he  subdivides 
into  three  varieties. 

In  1820,  Dr.  Thomson,  of  Edinburgh,  published  his  views  on  the  identity 
of  the  chicken-pox  of  Morton  and  Haberden  with  small-pox,  in  his  account 
of  the  varioloid  epidemic  of  Scotland  during  the  years  1818  and  1819. 

This  Opinion  of  Dr.  Thomson,  which  we  have  already  presented  in  detail 
in  a  former  portion  of  this  inquiry,  was  nothing  more  than  the  revival  of  an 
old  doctrine. 

The  learned  Dr.  John  Thomson  and  Mr.  Berard  urged,  in  favor  of  this 
opinion,  the  circumstance  of  variola  and  varicella  appearing  from  the  same 
exciting  cause,  whether  those  affected  have  been  vaccinated  or  not ;  and 
affirmed  that  persons  exposed  to  the  infection  of  chicken-pox  have  caught 
small-pox,  and  that  the  former  appears  only  in  those  whose  constitutions 
have  been  modified  by  the  influence  of  either  small-pox  or  cow-pox.  On 
this  subject  M.  M.  Schedel  and  Cazenave  remark,  that  in  those  epidemics 
which  they  have  had  opportunities  of  noticing  in  Paris,  the  several  erup¬ 
tions  might  be  classed  under  three  heads :  1,  variola  properly  so-called ; 
2,  the  malady  termed  varioloid  or  variola  modified  ;  3,  an  eruption  purely 
vesicular,  offering  every  appearance  of  varicella. 

The  same  cause,  namely,  variolous  infection,  seemed  to  develop  these 
several  eruptions,  which  were  observed  in  the  same  quarters,  in  the  same 
streets,  in  the  same  houses.  When  the  disease  made  its  appearance  among 


306 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


a  numerous  family,  some  had  small-pox,  some  modified  small-pox,  and 
others  chicken-pox.  One  circumstance  was  striking  to  every  one,  namely, 
the  mildness  of  the  disease  in  those  persons  who  had  been  vaccinated,  and 
in  the  majority  of  those  who  had  already  had  variola. 

Whilst  these  facts  appear  to  favor  the  old  view,  revived  by  Dr.  Thom¬ 
son,  many  cogent  arguments  have  been  urged  against  it  by  Abercrombie, 
Bryce,  Luders,  Fisher  and  others. 

1.  It  is  very  difficult  to  determine,  during  a  small-pox  epidemic,  whether 
the  occurrence  of  that  disease  among  individuals  coming  in  contact  with 
persons  infected  with  the  chicken-pox  is  rather  the  result  of  this  communi¬ 
cation  than  of  the  variolous  infection,  which,  at  that  moment,  develops  on 
all  sides. 

2.  Vesicular  varicella,  so-called,  is  not  transmitted  by  inoculation,  and 
never  produces  variola. 

3.  Those  persons  who  consider  chicken-pox  as  contagious  have  con¬ 
founded  it  with  modified  small-pox. 

4.  Varicella  appears  in  persons  who  have  not  been  vaccinated,  and  who 
have  never  had  the  variola ;  consequently,  in  such  cases,  it  cannot  be  re¬ 
garded  as  a  variola  modified  by  the  prior  existence,  either  of  the  disease 
or  of  vaccination. 

5.  Vaccination  practiced  shortly  after  the  disappearance  of  varicella, 
pursues  its  course  in  the  most  regular  manner,  which  never  happens  when 
vaccination  follows  variola. 

6.  The  progress  of  varicella  is  uniformly  the  same  whether  it  occurs  be¬ 
fore  or  after  vaccination,  or  after  variola. 

7.  Variola  sometimes  reigns  epidemically,  without  being  accompanied  by 
varicella ;  and  on  the  other  hand,  the  latter  may  become  epidemic  without 
being  attended  by  the  former. 

In  fact,  the  characters  of  the  eruption,  and  the  symptoms  of  varicella, 
differ  essentially  from  those  of  variola. 

Dr.  John  D.  Fisher,  of  Boston,  in  his  valuable  work  on  small-pox,  vario¬ 
loid  disease,  cow-pox  and  chicken-pox,  the  first  edition  of  which  was  pub¬ 
lished  in  1829,  gives  an  elaborate  description  of  chicken-pox. 

Dr.  Fisher  strongly  advocated  the  doctrine  that  u  the  small-pox  and  the 
varioloid  are  one  and  the  same  disease,  the  latter  being  only  a  modification 
of  the  former,  and  that  the  chicken-pox  is  a  separate  and  independent 
malady.  *  #  All  the  observations  that  I  have  been  able  to  make 

go  to  confirm  the  truth  of  this  opinion.  Indeed,  the  fact  that  the  small¬ 
pox  and  the  varioloid  are  capable  of  engendering  each  other,  and  that  the 
chicken-pox  has,  year  after  year,  prevailed  epidemically  in  many  of  our 
towns  in  which  the  small-pox  never  appeared,  and  consequently  without 
giving  rise  to  it,  settle  the  question  concerning  their  identity.” 

Dr.  John  Hughes  Bennett(l)  held  with  Dr.  Thomson,  the  opinion  that 
chicken-pox  was  a  modified  form  of  small-pox ;  and  this  view  has  been 
more  recently  revived  by  Dr.  Hamernjk,  of  Prague,  and  Professor  Hebra. 
On  the  other  hand  many  systematic  writers  of  this  day,  as  George 
Gregory, (2)  James  Copeland, (3)  Felix  Von  Memeyer,(4)  J.  F.  Marson,(5) 
Edward  Ballard  (6)  and  William  Aitken(7)  regard  the  disease  as  wholly 
distinct  from  small-pox  and  varioloid. 


(1.)  Clinical  Lectures  on  the  Principles  and  Practice  of  Medicine,  third  ed.,  p.  976. 
(2.)  Cyclopaedia  of  Practical  Medecine  ;  Philadelphia,  1859,  yol.  4,  pp.  636-639. 

(3.)  A  Dictionary  of  Practical  Medicine  ;  New  York,  1855,  yol.  1,  pp.  369-371. 

(4.)  A  Text  Book  of  Practical  Medicine ;  New  York,  1869,  vol.  2,  pp.  560-562. 

(5.)  A  System  of  Medicine,  Kenolds  ;  Philadelphia,  1879,  vol.  1,  pp.  124-127, 

(6.)  Vaccination,  its  Value  and  Alleged  Dangers;  a  prize  essay  ;  London,  1868,  p.  6. 
(7.)  The  Science  and  Practice  of  Medicine;  Philadelphia,  1872,  pp.  421-424. 


Spurious  Vaccination :  Joseph  Jones ,  M.  JD.  307 


DESCRIPTION  OF  VARICELLA. 

Under  the  name  chicken-pox  are  included  different  varieties  of  eruption 
generally  characterized  by  very  slight  and  brief  antecedent  fever,  consist¬ 
ing  of  vesicles  or  very  imperfect  pustules,  which  maturate  and  decline  in 
three,  four  and  five  days,  occurring  chiefly  during  infancy  and  childhood, 
but  also  at  adult  age,  and  occasionally  prevailing  epidemically.  The  gen¬ 
eric  term,  chicken-pox ,  comprises  three  species ,  or,  rather,  varieties,  which 
have  been  distinguished  from  each  other  for  very  many  years  in  America 
and  in  different  parts  of  England,  by  the  names  of  chicken-pox,  swine-pox 
and  hives. 

These  Willan  and  Bateman  distinguished,  according  to  the  form  of  their 
vesicles,  into:  First,  Varicella  Lentiformis  ;  second,  Varicella  Goniformis  ; 
and,  third,  Varicella  Globularis.  Dr.  Good  adopted  these  names  and  dis¬ 
tinctions,  but  added  a  fourth — the  Varicella  Oorymbosa — the  clustering  or 
confluent  chicken-pox,  which,  if  considered  at  all  as  a  distinct  variety,  is 
not  of  frequent  occurrence,  but  has  occasionally  been  observed  by  Bate¬ 
man,  Ring  and  Copeland. 

Anatomical  Appearances. — The  exanthema  begins  as  small,  red,  distinct 
spots,  which,  after  a  few  hours,  are  changed  to  liquid  vesicles  of  the  size  of 
a  pea  or  lentil,  by  a  copious  serous  effusion  between  the  cutis  and  epi¬ 
dermis.  These  vesicles  have  neither  a  central  depression  nor  a  cellular  form  a- 
tion.  After  a  time  these  contents  become  whey-like,  but  never  purulent, 
Thin  crusts  form  from  the  dried  vesicles,  which  fall  off  after  a  few  days, 
without  leaving  a  cicatrix.  From  the  form  of  the  vesicles,  the  different 
varei ties,  varicellae  globulosa,  ovalies,  lenticulares,  coniformes,  and  acu- 
minatae,  are  distinguished.  We  often  see,  especially  when  the  eruption 
is  very  extensive,  that,  besides  numerous  varicella  vesicles  running  the 
usual  course,  a  few  filled  with  pus  (varicellae  pustulosae)  acquire  the  ap¬ 
pearance  of  variola  pustules,  and  even  leave  cicatrices.  Since  the  form  of 
variola  pustules  is  not  specific,  but  exactly  resembles  that  of  some  erythma 
pustules,  we  should  not  attach  too  much  importance  to  the  external  resem¬ 
blance  of  some  of  the  efflorescences  in  varicella  to  those  in  variola,  and 
consequently  consider  the  two  diseases  as  identical. 

Symptoms.— There  are  no  symptoms  to  be  noticed  before  the  eruption, 
they  are  absent  or  slight ;  headache  and  feverishness  precede  the  eruption 
by  a  few  hours  ;  cough  is  sometimes  observed. 

j Eruption  Period. — The  eruption  appears  within  the  first  twenty-four  hours 
of  indisposition,  in  the  form  of  small  sore  spots,  slightly  accuminated; 
from  ten  to  fifteen  come  out  on  the  first  day  ;  they  appear  on  any  part  of 
the  body.  The  vesicle  is  preceded  by  a  red  spot  or  papule,  due  to  hyper- 
aemia  of  the  cutis  vera,  and  not  to  an  exudation  into  it,  for  tension  of  the 
skin  causes  the  varicellous  papule  to  disappear. 

On  the  second  day  there  may  be  a  hundred  or  a  hundred  and  fifty  fresh 
spots ;  those  of  the  previous  day  have  the  epidermis  raised  in  the  form  of  a 
bleb,  sometimes  perfectly  round,  containing  serosity  as  clear  as  water;  there 
is  no  inflammatory  areola.  The  vesicles  from  the  first  have  the  size  of  split 
peas,  and  that  size  is  soon  attained  or  exceeded.  The  patient  has  the  ap¬ 
pearance  of  having  been  subjected  to  a  shower  of  boiling  water. 

The  vesicle  is  unicellular,  not  umbilicated,  has  a  very  delicate  cuticle, 
aid  when  picked  collapses  perfectly. 

The  eruption  occupies  all  parts  of  the  body,  the  hairy  scalp  not  excepted. 
The  shape  of  the  vesicles  on  the  trunk  is  often  oval,  the  long  axis  being 
athwart  that  of  the  body.  Itchiness  is  common  and  impels  the  children  to 
rupture  the  vesicles. 


308 


Spurious  Vaccination  :  Joseph  Jones ,  31.  D. 


The  next  morning  a  hundred  or  a  hundred  and  fifty  new  spots  will  have 
appeared  during  the  night,  the  eruption  of  the  preceding  day  having  be¬ 
come  vesicular.  The  contents  of  vesicles  which  have  lasted  twenty-four 
hours  become  slightly  milky  ;  the  turbidity  however  is  uniform.  A  slight 
inflammatory  areola  appears.  This  nocturnal  outburst  of  spots,  which  be¬ 
come  vesicular  within  ten  hours,  is  repeated  for  four  of  five  succeeding 
nights  from  the  beginning  of  the  disease. 

Many  vesicles,  as  soon  as  they  have  attained  their  full  size,  get  broken 
and  so  encrust  at  once.  Those  that  remain  unbroken  present  on  the  third, 
fourth  or  fifth  day  of  their  existence  a  small  central  scab,  which  quickly 
attains  to  the  size  of  the  vesicle  in  a  day  or  two. 

The  scab  is  thin  and  granular $  it  falls  in  fragments,  and  leaves  no  en¬ 
during  redness  and  no  cicatrix.  If  the  vesicles  have  been  subjected  to 
unwonted  irritation,  the  scab  may  be  thick,  coherent,  and  may  leave  when 
it  falls  a  permanent  pit. 

The  following  table  presents  a  comparative  view  of  the  phenomena  of 
small-pox  and  chicken-pox  : 

Table,  Giving  a  Comparative  View  of  the  Phenomena  of  Small-Pox  and  Chicken-Pox. 

SMALL-POX.  CHICKEN-POX. 


1.  The  fever  is  ushered  in  by  a  cold  stage,  is  severe 
and  continues  three  or  four  days,  and  after  declining 
or  ceasing  in  the  eruptive  process,  it  commonly  re¬ 
appears  during  the  suppurative  stage,  or  between 
the  fifth  or  eighth  day  of  the  eruption. 


2.  The  eruption  is  often  preceded  or  accompanied 
by  an  erysipelatous  efflorescence. 

3.  The  eruption  does  not  break  out  until  the  third 
or  fourth  day  of  the  fever ;  it  appears  first  on  the 
face,  then  on  the  neck,  chest,  trunk  and  extremities, 
and  is  completed  in  the  course  of  two  days. 


4.  The  eruption  presents  itself  in  the  form  of  small 
red  circular  points  or  papula; ;  these  are  hard,  resist¬ 
ing  and  moveable,  and  communicate  to  the  finger  a 
shot-like  sensation.  They  scarcely  project  above 
the  surface,  but  are  easily  and  distinctly  felt  by 
drawing  the  finger  over  them. 


5.  The  eruption  seldom  becomes  vesicular  before 
the  end  of  the  second  or  the  commencement  of  the 
third  day,  and  the  vesicles  are  confined  to  the  sum¬ 
mits  of  the  pocks. 

6.  The  pustules  at  first  have  accuminated  summits; 
they  aftewards  become  rounded,  and  at  an  early 
period  present  slight  depressions  in  the  centre  of 
their  surfaces . 

7.  Eruption  is  situated  in  the  substance  of  the 
cutis. 

8.  The  pustules  after  they  have  become  vesicular 
are  distinguished  by  hard,  unyielding  bases. 


9.  The  pustules  are  composed  of  little  cells,  all  of 
which  communicate  with  each  other  ;  and  the  cuticu- 
lar  coverings  of  the  pocks  are  opaque,  tough  and  not 
easily  broken  - 

10.  The  pustules  are  at  an  early  stage  filled  with  a 
serous  secretion  ;  this  after  a  time  becomes  con¬ 
verted  into  purulent  matter  that  exhales  a  very  un¬ 
pleasant  and  peculiar  odor. 

11 .  The  pustules  remain  whole  until  they  are  six 
or  seven  days  old,  when  some  of  them  commonly  be¬ 
come  ruptured,  and  permit  a  little  of  the  virus  to 
ooze  out  upon  their  surface;  but  they  still  retain 
their  form  and  prominence. 


1.  The  fever  is  not  often  preceded  by  a  cold  stage, 
is  uniformly  light  and  is  frequently  insensible ;  it 
seldom  continues  more  than  two  days,  and  never  re¬ 
appears  after  it  has  once  ceased.  When,  however, 
the  vesicles  appear  in  successive  crops,  the  fever 
lasts  longer  and  continues  until  the  eruption  is  com¬ 
pleted. 

2.  This  efflerescence  does  not  take  place. 

3.  The  eruption  breaks  out  by  the  termination  of 
the  first  or  on  the  second,  and  almost  invariably 
before  the  end  of  the  third  day  of  the  fever;  it  usu¬ 
ally  appears  about  the  breast  and  shoulders  first, 
afterwards  on  the  face  and  extremities.  It  fre¬ 
quently  appears  in  successive  crops  for  four  or  five 
days. 

4.  The  eruption  likewise  breaks  out  in  small  in¬ 
flamed  spots,  but  these  are  not  papular  in  their  origin 
and  are  not  exactly  circular,  but  tend  to  an  oblong 
figure.  They  may  be  distinctly  felt  by  the  finger, 
but  they  are  yielding  under  it,  and  are  destitute  of 
the  tubercular  hardness  and  rolling  motion  which 
characterize  the  variolous  eruption  at  the  same 
period. 

5.  The  eruption  is  vesicular  from  the  beginning  or 
from  the  early  part  of  the  first  day,  and  by  the  sec¬ 
ond  day  the  whole  surface  of  the  pocks  are  converted 
into  vesicles  which  resemble  little  bladders  of  trans¬ 
parent  fluid. 

6.  The  vesicles  are  usually  lenticular  in  form,  but 
are  sometimes  conoidal  or  globate,  and  present  one 
shape  through  their  course,  or  until  they  become 
ruptured. 

7.  Not  formed  in  the  true  skin,  but  upon  its  sur¬ 
face,  not  in  the  cellular  tissue  between  the  skin  and 
cutis. 

8.  The  vesicles  are  destitute  of  tuberculous  bases, 
are  yielding,  and  easily  give  way  underpressure,  and 
communicate  to  the  finger  a  soft,  elastic  sensation,  or 
a  feeling  similar  t>o  that  which  a  minute  globule  of 
fine  sponge  softened  with  water  would  give  rise  to 
when  pressed. 

9.  The  vesicles  are  composed  of  a  single  cavity,  and 
the  coverings  are  extremely  thin  and  fragile,  are  di- 
apthanous  and  very  easily  broken. 

10.  The  vesicles  contain,  when  fully  matured,  only 
a  whitish  transparent,  serous  fluid;' this  never,  ex¬ 
cept  through  accident,  becomes  pus,  and  is  destitute 
of  any  unpleasant  odor. 

11.  The  vesicles  often  become  broken  in  two  or 
three  days  after  thoir  appearance,  and  permit  the 
whole  of  their  contents  to  escape;  their  coverings 
then  sink  down  and  collapse,  and  the  vesicles  become 
flattened,  or  lose  thoir  original  form. 


/ 


Spurious  Vaccination :  Joseph  Jones ,  M.  D.  309 


SMALL-POX. 

12.  The  pustules  break  out  simultaneously,  pur¬ 
sue  a  regular  march  and  arrive  at  maturity  about 
the  same  time.  Desiccation  does  not  commence  un¬ 
til  about  the  eighth  day  of  the  eruption.  The  pro¬ 
cess  of  eruption  of  suppuration  and  of  desiccation 
constitute  three  successive  periods,  rendered  distinct 
from  each  other  by  their  duration  ;  the  first  occupies 
about  three  days,  and  the  other  two  about  five  days 
each. 


13.  A  general  swelling  of  the  cutaneous  surface 
takes  place  just  before  Jthe  pustules  begin  to  desic¬ 
cate. 

14.  The  scabs  fall  off  in  a  single  piece.  The  sur¬ 
faces  of  those  who  have  had  the  disease  remains  spot¬ 
ted  for  a  long  time.  The  scars  which  remain  per¬ 
manently  in  the  skin  are  irregular  in  figure  and  pre¬ 
sent  uneven  surfaces. 


15.  The  small-pox,  even  when  distinct  and  of  mod¬ 
erate  mildness,  is  a  disease  of  fifteen  or  twenty  days 
in  duration,  and  often  proves  fatal. 

16.  Communicated  by  contagion  and  inoculation, 
In  varioloid  or  modified  small  pox,  the  eruptions,  for 
a  considerable  time  after  the  scabs  have  fallen,  leave 
little  kernels  or  tuberculous  elevations  in  the  skin. 

17.  The  poison  of  small  pox, varioloid  and  cow-pox, 
in  a  majority  of  cases,  preserve  the  system  from  sec¬ 
ond  attacks  of  the  same  disease. 

18.  Children  have  been  attacked  by  varicella  who 
have  been  vaccinated,  or  had  variola  only  a  few  weeks 
before, 


CHICKEN-POX. 

12.  The  vesicles  generally  break  out  in  successive 
crops  for  a  number  of  days,  in  which  case  a  great 
variety  may  be  observed  among  them  ;  some  are  ap¬ 
pearing,  whilst  others  are  fully  formed,  shriveled  or 
crusted.  Desiccation  commences  on  the  fifth  day, 
or  as  soon  as  the  vesicles  are  ruptured,  and  some¬ 
times  on  the  second,  third  or  fourth  days.  The  three 
periods  of  eruption,  suppuration  and  desiccation 
seem  to  be  confounded  in  consequence  of  the  pocks 
in  successive  crops,  the  time  of  their  duration  sel¬ 
dom  exceeding  eight  days. 

13.  Desiccation  is  never  perceived  by  any  exten¬ 
sive  swelling  of  the  cutaneous  surface. 

14.  The  scabs  do  not  usually  fall  off  in  a  single 
piece,  but  in  small  fragments  of  different  forms  and 
sizes.  The  marks  remaining  in  the  skin  after  des¬ 
quamation  are  but  slightly  colored,  and  the  redness 
if  apparent  soon  disappears 

When  scars  are  left  in  the  skin  by  the  vesicles 
they  are  regular  and  figure  in  present  smooth  sur¬ 
faces  . 

15.  Chicken-pox  runs  its  course  and  is  completed 
in  five  or  six  days,  or  in  eight  or  ten  at  the  most,  and 
it  never  of  itself  proves  fatal. 

16.  Not  communicable  by  inoculation,  as  shown  by 
Dr.  Bryce.  The  chicken-pox  never  gives  rise  to 
true  small-pox  or  varioloid,  neither  is  it  ever  com¬ 
municable  by  variola  or  varioloid 

17 .  The  chicken-pox  when  it  prevails  epidemically, 
attacks  individuals  who  have  never  had  the  variolous 
and  the  cow-pox  diseases,  with  equal  readiness  as  it 
does  those  who  have  had  neither. 

18.  Varicella  frequently  occurs  in  children  that 
have  never  been  vaccinated,  and  its  occurrence  does 
not  prevent  them  taking  small-pox,  nor  prevent 
successful  vaccination.  Varicella  must,  therefore, 
be  regarded  as  a  specific  disease. 


SECTION  IV.— DRIED  VACCINE  LYMPH,  OR  SCABS,  IN  WHICH 
DECOMPOSITION  HAS  BEEN  EXCITED  BY  CARRYING  THE 
MATTER  ABOUT  THE  PERSON  FOR  A  LENGTH  OF  TIME, 
AND  THUS  SUBJECTING  IT  TO  A  WARM  MOIST  ATMOS¬ 
PHERE. 

Tlie  effects  of  such  decomposing  matter,  resemble  those  of  the  putrid 
matter  received  in  dissecting  wounds. 

The'practice  of  some  physicians  to  mix  a  considerable  portion  of  powdered 
vaccine  scab,  with  water  on  a  glass  slide,  and  to  use  this  in  a  number  of 
vaccinations,  from  house  to  house,  is  not  unattended  with  danger,  especi 
ally  during  warm  weather.  The  danger  of  this  filthy  procedure,  is  three¬ 
fold.  First,  when  the  dried  scab  is  used,  the  chances  of  'communicating 
the  vaccine  disease  by  inoculation  are  lessened,  and  there  is  greater  danger 
of  communicating  other  diseases  through  the  medium  of  this  dried  mass  of 
pus,  blood,  lymph  and  cellular  tissue.  Second,  when  animal  matter  is 
finely  divided  and  mixed  with  water,  and  subjected  to  a  temperature  of 
near  summer  heat,  all  the  conditions  are  supplied  for  those  active  chemical 
chauges,  which  in  nitrogenized  matters,  frequently  lead  to  the  formation 
of  poisons,  capable  of  exciting  rapid  and  destructive  changes  in  the  living 
organism.  Third,  in  using  matter  from  a  common  store,  fresh  blood  is  fre¬ 
quently  conveyed  from  the  patient  vaccinated,  upon  the  instrument  or  lan¬ 
cet,  to  the  vaccine  mixture.  The  liability  to  putrefactive  change  is  not 
only  increased  by  this  mixture,  but  also  the  danger  of  communicating  sec¬ 
ondary  syphilis,  or  any  other  disease  capable  of  being  transmitted  by  vac¬ 
cination  is  augmented.  When  a  score,  or  more,  cases  are  vaccinated  from 


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Spurious  Vaccination:  Joseph  Jones,  M.  D. 


the  same  supply,  and  with  the  same  instrument,  if  the  greatest  precaution 
is  not  employed,  more  or  less  blood  from  different  individuals  becomes  mixed 
with  the  virus.  The  method  so  common  in  America,  of  vaccinating  with 
the  dried  scab,  should  be  performed  with  great  care. 

In  the  warm  climate  of  the  Southern  States,  it  is  especially  difficult  to 
preserve  vaccine  matter  for  any  length  of  time,  without  more  or  less  change 
and  even  putrefaction.  The  length  of  time  which  the  vaccine  virus  will 
retain  its  active  properties,  will  depend  upon  the  temperature  and  moisture 
of  the  climate. 

The  true  mode  of  preserving  and  propagating  the  vaccine  virus,  is  that 
recommended  by  Jenner,  viz. ;  the  inoculation  of  the  lymph  directly  from 
the  arm  at  a  period  not  later  than  the  eighth  day.  By  a  succession  of  such 
vaccinations  upon  a  number  of  children,  transported  for  this  purpose,  Dr. 
Francis  Xavier  Balmis,  Surgeon-Extraordinary  to  the  King  of  Spain,  im¬ 
parted  vaccination  to  many  nations  during  his  voyage  round  the  world 
(1803-1806)  executed  for  the  sole  purpose  of  carrying  to  all  the  possesions 
of  the  King  of  Spain  beyond  the  seas,  and  to  those  of  other  nations,  the 
inestimable  gift  of  vaccine  inoculation. 

At  an  early  day  in  the  history  of  vaccination,  Dr.  Jenner  made  numerous 
attempts  to  send  the  vaccine  virus  to  the  most  distant  possessions  of  the 
English  in  the  East.  After  the  failure  of  the  virus  sent  by  ships  to  India 
twenty  recruits,  or  men  of  any  description  who  had  not  had  the  small  pox, 
should  be  selected ;  and  a  surgeon  appointed  to  attend  the  successive  vac¬ 
cinations.  Dr.  Jenner  thus  engaged  that  the  vaccine  disease  should  be 
carried  in  its  most  perfect  state  to  any  English  Settlements.  Upon  the  re¬ 
jection  of  this  proposition  by  the  government,  he  formed  the  plan  of  equip¬ 
ping  and  sending  out  a  vessel  to  India  with  such  arrangements  and  such  a 
number  of  men  as  to  ensure  the  continuous  transmission  of  the  vaccine 
virus,  by  private  subscriptions,  and  put  down  his  own  name,  for  one 
thousand  guineas.  Before  his  design  could  be  carried  into  execution, 
tidings  arrived  from  the  east,  that  Dr.  De  Carro  had  succeeded  in  forward¬ 
ing  vaccine  matter  from  Vienna  to  Constantinople,  and  from  thence  to 
Bombay.  The  manner  in  which  Dr.  De  Carro,  (by  whose  unwearied  labors 
the  vaccine  disease  was  first  disseminated  over  Germany,  Venice,  Lom¬ 
bardy  and  other  parts  of  Europe),  transmitted  the  vaccine  virus  to  India, 
possesses  great  interest  at  the  present  time,  when  so  much  carelessness  is 
manifested  by  the  profession  both  in  the  selection  and  in  the  preservation 
of  the  virus. 

Many  disappointments  having  arisen  from  the  difficulty  of  transmitting 
it  in  an  active  state  to  distant  countries,  Dr.  De  Carro  employed  every  ex¬ 
pedient  that  ingenuity  or  experience  could  suggest  to  obviate  them.  Vari¬ 
ous  methods  had  been  tried.  Impregnated  lint,  or  threads  enclosed 
between  plates,  or  in  bottles  and  in  tubes  closed  up  with  wax.  The  prac¬ 
tice  of  imbuing  the  points  of  common  steel  lancets  was  soon  abandoned. 
To  these  succeeded  lancets  of  silver,  silver  gilt,  gold  and  ivory.  After  a 
series  of  trials  Dr.  De  Carro  gave  the  preference  to  ivory,  which  he  con¬ 
sidered  to  be,  in  all  respects,  the  most  secure  vehicle  for  transporting  the 
virus.  On  lancets  of  this  material  it  was  sent  from  Breslau  to  Moscow, 
vffiere,  under  the  patronage  and  actual  inspection  of  the  Russian  Empress, 
it  completely  succeeded.  As  that  which  was  destined  for  Bagdad  would 
be  exposed  to  the  accidents  of  a  long  journey,  in  a  climate  heated  by  a 
scorching  sun,  he  took  special  care  to  protect  it  as  much  as  possible  from 
external  influence.  He  sent  some  on  laucets  of  silver,  silver-gilt  and  ivory; 
Le-also  impregnated  some  English  lint  with  the  vaccine  fluid,  and  enclosed 
it  between  glasses ;  and  when  he  had  properly  secured  them  he  dipped 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


311 


them  at  a  wax-chandleFs  till  they  formed  a  solid  ball,  which  he  enclosed  in 
a  box  filled  with  shreds  of  paper.  In  this  state  the  packet  was  safely  con¬ 
veyed  across  the  Bosphorus,  and  passed  over  the  whole  line  of  deserts ; 
and  he  had  the  satisfaction  of  hearing  that,  on  its  arrival  on  the  banks  of 
the  Tigris,  its  contents  were  still  liquid  and  succeeded  on  the  first  trial.  It 
was  received  on  the  thirty-first  of  March,  1802,  upon  the  banks  of  the 
Tigris,  and  before  the  end  of  June  it  had  reached  Bombay. 

Dr.  De  Carro,  in  a  letter  to  Dr.  Jenner,  dated  Vienna,  April  22,  1803, 
thus  describes  the  method  which  he  had  employed  for  the  preservation  of 
the  vaccine  virus : 

“  I  do  not  know  whether  you  are  well  informed  of  the  great  improvement  which  MM.  Ballhorn  and  Stro 
meyer  have  made  to  the  glasses  invented  by  you.  They  have  taught  us  a  simple  and  easy  manner  to  pre 
serve  the  vaccine  ljnmph  fluid  during  an  indefinite  term.  The  Hanoverian  vaccinators  take  a  small  bit  of 
English  charpie,  which  you  call,  I  believe,  dry  lint.  The  quantity  must  be,  of  course,  equal  to  the  concavity 
of  the  glass.  The  pustule  then  is  punctured  by  a  circular  or  half-circular  incision  with  the  lancet,  so  as  to 
open  a  greater  number  of  the  cells  forming  the'  vaccine  pustule  covered  with  the  same  pellicle.  The  lint  is 
applied  upon  the  pustule  on  the  most  wooly  side,  so  as  to  act  better  as  a  siphon.  It  pumps  in  a  very  short 
time  a  sufficient  quantity  of  vaccine  fluid  to  saturate  it  as  completely  as  if  it  had  been  dipped  in  a  glass  of 
water,  particularly  if  the  lint  is  now  and  then  gently  pressed  with  the  point  or  back  of  the  lancet.  When  it 
is  quite  full  you  take  it  with  the  lancet  and  place  it  carefully  in  the  cavity  of  the  glass  ;  you  put  a  drop  of 
oil,  or  a  little  mucilage,  upon  the  internal  surface  of  the  glasses  ;  you  make  the  flat  bit  of  glass  slide  upon 
the  charpie,  so  as  to  exclude  the  air  as  much  as  possible  ;  you  tie  the  two  bits  with  thread,  and  seal  the 
edges.  To  prevent  the  access  of  light  I  commonly  fold  it  in  a  black  paper,  and  when  I  was  desired  to  send 
it  to  Bagdad,  I  took  the  precaution  of  going  to  a  wax-chandler’s,  and  surrounded  the  sealed-up  glasses  with 
so  much  wax  as  to  make  balls.  With  this  careful  manner  it  arrived  still  fluid  on  the  banks  of  the  Tigris.” 

( Life  of  Edward  Jenner ,  vol.  1,  pp.  420,  430.) 

01 

The  method  so  extensively  employed  in  America,  of  preserving  the  entire 
scab  after  it  separates  from  the  arm,  by  enclosing  it  in  wax,  is  not  only  less 
reliable  than  the  method  practiced  by  Drs.  Jenner  and  De  Carro  and  others, 
but  it  is  attended  with  greater  danger,  from  the  changes  induced  by  heat 
and  moisture. 

Shortly  after  the  introduction  of  vaccination  into  the  United  States,  by 
Dr.  Waterhouse,  ignorant  persons,  in  Hew  England,  not  of  the  medical 
profession,  who  were  stimulated  by  avarice  to  carry  on  a  traffic  in  vaccine 
matter,  obtained  the  shirt-sleeves  of  patients  which  had  been  stiffened  by 
the  purulent  discharge  from  an  ulcer  consequent  on  vaccination.  These 
they  cut  iuto  strips,  and  sold  about  the  country  as  impregnated  with  the 
true  vaccine  virus.  Several  hundred  persons  are  said  to  have  been  inocu¬ 
lated  with  this  poison,  which  in  some  cases  produced  great  constitutional 
disturbance. 


SECTION  Y— THE  MINGLING  OF  THE  VACCINE  VIRUS  WITH 
THAT  OF  THE  SMALL  POX— MATTER  TAKEH  FROM  THOSE 
WHO  WERE  VACCINATED  WHILE  THEY  WERE  LABORING 
URDER  THE  ACTION  OF  THE  POISON  OF  SMALL-POX,  WAS 
CAPABLE  OF  PRODUCING  A  MODIFIED  VARIOLA,  AND 
COMPARATIVELY  MILD  DISEASE  IN  THE  INOCULATED, 
AND  WAS  CAPABLE  OF  COMMUNICATING  BY  EFFLUVIA 
SMALL  POX  IN  ITS  WORST  CHARACTER  TO  THE  UNPRO¬ 
TECTED— OB  VERVATIONS  OF  DRS.  JENNER,  WOODVILLE, 
ADAMS,  WILLAN,  GREGORIE,  HENNEN,  FOWLER  AND 
BOUSQUET,  UPON  THE  RELATIONS  OF  THE  VACCINE 
DISEASE  AND  SMALL  POX. 

In  more  than  one  instance  small-pox  was  disseminated,  by  vaccination 
with  what  was  considered  as  vaccine  virus.  In  all  such  cases 
the  virus  was  obtained  from  patients  who  were  laboring  under 


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Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


the  action  of  the  poison  of  small-pox,  at  the  time  of  the  insertion  of 
the  vaccine  matter.  Some  cases  of  small-pox  were  said  to  have  originated 
from  the  employment  of  small-pox  scabs,  which  had  been  sent  through  the 
lines  by  the  enemy  as  good  genuine  vaccine  matter.  As  far  as  my  knowledge 
extends,  such  accidents  did  not  arise  from  the  willful  and  malicious  dissemina¬ 
tion  of  small-pox  matter,  as  was  charged  publicly  through  the  newspapers  ; 
but  they  were  referable  to  the  careless  employment  of  vacciue  matter  de¬ 
rived  from  patients  in  small-pox  hospitals,  or  from  members  of  households 
vaccinated  after  small-pox  had  appeared  in  their  midst,  and  consequently 
after  the  introduction  of  poison  iuto  their  systems. 

Such  accidents  are  by  no  means  new  to  the  profession,  for,  more  that  half 
a  century  ago,  they  had  well  nigh  proved  fatal  to  the  infant  cause  of  vac¬ 
cination.  Many  of  the  patients  experimented  upon,  by  Dr.  Woodville,  at 
the  Small-Pox  Hospital  in  Loudon,  were  not  only  exposed  to  a  variolous 
atmosphere,  but  they  actually  had  small-pox  matter  inserted  into  their 
arms  on  the  third  and  fifth  days  after  vaccination.  Dr.  Jenner  had 
positively  asserted  that  pustules  do  not  belong  to  the  cow-pox:  Dr.  Wood¬ 
ville,  on  the  contrary,  affirmed  that  three-fifths  of  the  patients  whom  he 
had  inoculated  with  vaccine  matter,  had  pustules  not  to  be  distinguished 
from  variolous  ones.  Dr.  Wood  vile,  in  an  interview  which  he  held  with 
Dr.  Jenner  on  the  twenty-third  of  March,  1798,  mentioned  that  the  cow-pox 
had  been  communicated  by  effluvia,  and  that  the  patient  had  it  in  the  con- 
fluent  way.  Dr.  Jenner  is  said  to  have  remarked  on  this  marvellous  occur¬ 
rence,  “Might  not  the  disease  have  been  the  confluent  small-pox  commu¬ 
nicated  by  Dr.  Woodville,  as  he  is  always  full  of  the  infection?” 

Such  careless  experiments  as  those  of  Dr.  Woodville,  conducted  in  a 
small-pox  hospital  !  excited  the  strongest  feelings  of  disappointment  among 
the  principal  medical  men  of  London,  and  for  a  season  threw  doubt  upon 
the  accuracy  of  Dr.  Jenner’s  statement.  And  it  was  only  after  careful  in¬ 
vestigation  that  Dr.  Jenner  was  able  to  demonstrate  that  the  London  cow- 
pox  was  somehoui  or  other  compounded  with  smallpox. 

This  contaminated  matter  from  the  London  small-pox  hospital,  was  dis¬ 
tributed  to  different  parts  of  the  country  by  Dr.  Pearson,  and  caused  most 
unpleasant  accidents.  Some  of  this  contaminated  matter  fell  into  the  hands 
of  Mr.  Andre,  Surgeon  at  Petworth,  and  fourteen  persons  who  were  inocu¬ 
lated  with  it  had  variolous  eruptions  and  in  some  cases  suffered  severely. 
Lord  Egremont  wrote  a  long  letter  on  this  occasion  to  Dr.  Jenner,  detailing 
the  occurrence  at  Petworth.  The  reply  of  Dr.  Jenner  to  this  letter  is  worthy 
of  careful  consideration,  in  the  light  which  it  throws  upon  similar  accidents 
occuring  during  the  recent  war. 

DR.  JENNER  TO  LORD  EGREMONT. 

My  Lord — I  am  extremely  obliged  to  your  Lordship  for  your  kindness  in  giving  me  so  fully  the  account 
of  the  late  inoculation  at  Petworth;  a  subject  which,  before,  I  did  not  clearly  understand;  and  which,  of 
course,  had  given  me  much  vexation.  I  will  just  briefly  lay  before  you  part  of  the  history  of  the  cow-pox 
inoculation  since  my  experiments  were  first  publicly  made  known,  which  may  tend  in  some  measure  to  ex¬ 
plain  in  what  manner  pustules  may  be  produced. 

About  a  twelvemonth  ago,  Dr.  Woodville,  Physician  to  the  Small-pox  Hospital,  procured  some  virus  from 
a  cow  at  one  of  the  London  milk  farms,  and  inoculated  with  it  several  patients  at  the  Small  pox  Hospital. 
Fearful  that  the  infection  was  not  advancing  properly  in  some  of  their  arms,  he  inoculated  them  (some  on 
the  third,  others  on  the  fifth  day  afterwardsj  with  smallpox  matter.  Both  inoculations  took  effect;  and 
thus,  in  my  opinion,  a  foundatien  was  laid  for  much  subsequent  error  and  confusion ;  for  the  virus  thus 
generated  became  the  source  of  future  inoculations,  not  only  in  the  hospital,  but  in  London,  and  many  parts 
of  the  country. 

Hearing  a  murmur  among  medical  people  that  the  cow-pox  was  not  the  simple  disease  I  had  described, 
but  that  in  many  instances  it  produced  as  many  eruptions  and  was  attended  with  us  much  severity  as 
the  small-pox,  I  went  to  town  with  the  view  of  inquiring  into  the  cause  of  this  deviation.  Dr.  Woodville 
at  once  invited  me  to  the  Small-pox  Hospital,  and  very  ingenously  told  me  the  whole  of  his  proceedings 

The  inoculated  patients  were  shown  t@  me,  and  though  some  were.without  eruptions  and  exhibited  the 
appearance  of  the  true  cow-pox,  others  were  very  full  of  them,  and  I  could  not  discern  any  differences  be¬ 
tween  them  and  the  perfect  small-pox.  I  therefore  did  not  hesitate  to  tell  the  Doctor  that  it  clearly  appeared  to 
me  that  the  small-pox  had  crept  into  the  constitution  with  the  cow-pox ;  that  I  did  not  consider  them  as  two 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


313 


distinct  diseases,  but  as  varieties  only  of  the  same  disease  ;  and  therefor#  they  might  co-exist  in  the  same 
constitution,  and  that  thus  a  mixed  disease  had  been  produced.  I  communicated  also  the  same  sentiment  to 
Dr.  Pearson,  who  was  then,  and  had  been,  busily  employed  not  only  in  inoculating  from  this  source,  but  in 
dispensing  threads  embued  in  the  virus  to  various  places  in  our  own  country,  and  to  many  parts  of  the 
cont  inent  .  Forseeing  what  was  likely  to  ensue  from  these  hasty  measures,  I  remonstrated  against  them,  but 
was  not  listened  to.  In  many  places  where  the  threads  were  sent  a  disease  like  a  mild  small-pox  frequently 
appeared ;  yet,  curious  to  relate,  the  matter,  after  it  had  been  used  six  or  seven  months,  gave  up  the  vario¬ 
lous  character  entirely,  and  assumed  the  vaccine  ;  the  pustules  declined  more  and  more,  and  at  length  be¬ 
came  extinct.  I  made  some  experiments  myself  with  this  matter,  and  saw  a  few  pustules  on  my  iirst  pa¬ 
tients  ;  but  in  my  subsequent  inoculations  there  were  none .  From  what  I  once  saw  at  the  hospital,  I  had  rea¬ 
son  to  think  that  some  of  these  threads  sent  out  were  not  only  stained  with  small  pox  matter  from  the  con¬ 
tamination  spoken  of,  but  that  they  had  sometimes  a  dip  in  a  real  small-pox  arm;  as  the  patients  were  all 
mingled  together  at  the  hospital,  and  stood  with  their  arms  bare,  ready  to  afford  matter  one  among  another. 
'Without  making  any  further  trials  with  matter  from  the  cow  managed  in  another  way,  Dr.  W.  published  a  vol¬ 
ume  containing  the  result  of  his  practice,  which  certainly  dampened  the  spirits  of  many  who  had  from  my 
represention  taken  up  a  high  opinion  of  the  cow-pock  inoculation  A  thought  now  struck  me  that,  if  pos¬ 
sible,  it  would  be  proper  to  procure  matter  from  a  London  cow,  and  compare  its  effects  with  that  generated 
in  the  country. 

Unwilling  to  determine  in  a  hurry,  I  procured  matter  from  a  London  cow,  conceiving  it  possible  that  the 
animal  in  this  situation  might  generate  matter  possessing  qualities  differing  in  some  measure  from  that 
which  is  more  in  a  state  of  nature  in  our  meadows  here  ;  but  the  result  convinced  me  that  the  virus  was  the 
same,  as  500  people  -were  inoculated  from  this  source  without  the  appearance  of  any  pustules.  But  this  his¬ 
tory,  my  lord,  does  not  tell  you  by  what  means  the  pustules  appeared  at  Petworth  ;  but  it  informs  you  how 
errors  may  arise,  and  how  they  may  be  persisted  in,  There  is  another  source  which  I  fear  will  be  too  com¬ 
mon.  Lancets  are  often  carried  in  the  pocket  of  a  surgeon  with  small-pox  dried  upon  them,  for  the  purpose 
of  inoculation.  A  gentleman  some  time  ago  sent  a  lancet  here  to  have  it  charged,  as  it  is  called,  with  cow- 
pox  matter  ;  perceiving  it  stained  at  the  point  with  some  dried  fluid,  it  was  sent  back,  when  he  immediately 
recollected  that  his  lancet  was  prepared  with  the  matter  of  the  small-pox.  What  confusion  might  have 
happened  from  this  ;  and  how  narrowly  we  escaped  it !  For  it  was  but  an  equal  chance,  probably,  that  had 
the  lancet  been  used  a  direct  small  pox  might  have  been  produced,  for  the  chances  Were  equal  whether  it 
produced  one  disease  or  the  other. 

It  may  be  necessary  to  observe,  it  is  improbable  that  a  mixture  of  the  two  matters  used  in  this  way 
would  have  produced  a  mixed  disease,  as  two  different  diseased  actions  cannot  go  forward  in  one  and  the 
same  part  at  the  same  time,  so  that  the  disease  would  have  been  either  the  perfect  cow-pox  or  the  perfect 
small-pox. 

The  matter  which  was  made  use  of,  I  hear,  came  from  Dr.  Pearson  ;  and  doubtless  Mr.  Keate  will  have 
candor,  and,  I  hope,  industry  enough  to  trace  the  error  to  its  source.  That  there  was  error  somewhere,  of 
which  Mr.  Keate  became  the  innocent  cause,  is  a  fact  that  I  think  will  not  admit  of  controversy.  I  have 
sometimes  seen,  perhaps  in  one  case  in  a  hundred,  a  few  scattered  pimples  about  the  body  and  some¬ 
times  rashes;  but  these  have  arisen  from  the  inflammation  and  irritation  of  the  arm,  for  it  is  very  well 
known  that  many  acrid  substances,  applied  to  the  skin,  so  as  to  produce  local  inflammation,  will  frequently 
occasion  a  similar  appearance. 

This  letter,  in  which  Dr.  Jenner  announces  the  doctrine  held  and  taught 
by  his  triend  John  Hunter,  (viz.,  two  diseased  actions,  cannot  go  forward 
in  one  and  the  same  part,  at  the  same  time),  is  important  not  only  in  the 
demonstration  which  it  affords  of  the  transmission  of  both  small-pox  and 
cow-pox,  at  the  same  time,  through  the  same  mass  of  matter,  but  it  also 
contains  a  strong  argument  for  the  view  held  by  Jenner  that  these  were 
not  distinct  disease,  but  only  varieties  of  the  same  disease. 

Dr.  Adams,  in  his  work  on  Morbid  Poisons,  gives  the  following  interest¬ 
ing  and  important  observations,  which  confirm  the  correctness  of  the  views 
of  Dr.  Jenner. 

“It  is~to  be  hoped  that  a  very  correct  attention  to  the  processes  of  variolation  and 
vaccination  will  enable  us  to  ascertain  the  exact  analogy  which  exists  between  the  two 
morbid  poisons  evidently  distinct,  yet  not  entirely  separated  by  those  laws  which  we 
have  to  trace  in  others.  The  correspondence  in  the  laws  of  each — the  peculiarities  in 
which  they  differ — the  manner  in  which  they  interrupt  each  other’s  action,  and  the  man¬ 
ner  in  which  they  may  be  made  to  act  in  concert,  are  all  equally  interesting,  and  the 
daily  subjects  of  experiment  and  observation.  At  present  the  following  may  be  consid¬ 
ered  as  established  facts : 

“  Each,  when  inserted,  requires  about  the  same  time  to  produce  its  local  effects. 

“A  subject,  that  has  regularly  passed  through  either,  is  insensible  to  the  future  consti- 
tional  effects  to  the  variolous  poison. 

“  Each  will  produce  secondary  eruptions,  having  the  same  property  of  infecting  as 
the  primary  ;  but  the  secondary  eruptions  appear  more  than  ninety-nine  times  in  a  hun¬ 
dred  in  small-pox,  and  not  once  in  three  hundred,  if  the  skm  is  otherwise  entire,  in  the 
cow-pox. 

“  In  the  small-pox,  secondary  pustules  appear  whilst  the  primary  is  advancing,  and 
maturate  two  or  three  days  after  them.  In  cow-pox,  when  secondary  vesicles  appear, 
it  is  not  till  the  primary  has  begun  to  scab. 

“  The  small-pox  may  infect  by  the  effluvia,  the  cow-pox  can  only  be  communicated  by 
the  sc-retion  from  the  local  infection. 

“  When  these  poisons  are  inserted  at  the  same  time  in  the  same  part  of  the  same  sub¬ 
ject,  by  mixing  the  secretion  of  each,  only  one  will  produce  its  effect. 

P 


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Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


“When  inserted  separately  in  different  parts  of  the  same  subject,  each  will  produce  its 
local  effect,  and  at  the  same  time. 

“If  cow-pox  is  inserted  at  the  same  time  that  the  subject  is  exposed  to  a  vitiated  at¬ 
mosphere,  the  former  will  supersede  the  effects  of  the  latter.  If  inserted  four  days  later, 
the  effect  will  be  less  certain,  but  as  far  as  can  be  ascertained,  not  more  uncertain  than 
the  variolous  insertion,”  (Adams  on  Morbid  Poisons,  pp  10-16.)  Dr.  Adams  gives  sev¬ 
eral  instances  to  show  that  the  vaccine  and  variolous  diseases  may  be  confounded  in  cer¬ 
tain  cases,  that  is-,  that  the  laws  peculiar  to  one  may  occasionally  influence  the  other. 
(See  pp.  16-20.) 

“  The  invaluable  Jenneriau  discovery  has  introduced  us  to  a  morbid  poison,  the  prop¬ 
erties  of  which  are  different  from  all  others  that  we  are  acquainted  with  in  superseding 
the  constitutional  susceptibility  to  another.  As  such  a  law  as  this  is  unknown  in  any 
other  two  morbid  poisons,  we  might  suspect  the  analogy  between  these  two  would  be 
cleai'er  than  between  any  other  two.  We  might  even  expect  that  the  characters  of 
the  two  might  be  altered  by  applyiug  both  at  the  same  time,  and  also  that  the  phenom¬ 
ena  of  one  might  imitate  the  other  in  such  a  manner  as  to  render  the  distinction  between 
the  two  often  doubtful.  It  is,  therefore,  rather  a  matter  of  surprise  that  the  distinction 
should  be  so  regularly  reserved,  and  the  laws  which  separate  other  morbid  poisons  so 
rarely  infringed. 

“The  next  thing  I  would  remark  is  that  small-pox  and  cow-pox,  contrary  to  the  law 
of  all  morbid  poisons,  which  are  different  in  their  action,  will  proceed  together  in  the 
same  person  without  the  smallest  interruption  of  each  other’s  course.  If  inserted  nearly 
at  the  same  time,  in  the  same  person,  each  proceeds  in  the  same  course  as  if  it  were  in 
two  different  subjects  ;  if  inserted  nearly  in  the  same  spot,  the  two  form  one  common 
areola,  but  the  vesications  are  distinct,  and  each  preserves  its  own  character,  till  that  of 
small-pox  becomes  purulent  from  suppuration  for  the  separation  of  the  slough.  If  secon¬ 
dary  pustules  follow  from  the  small-pox,  and  they  should  continue  coming  out  till  the 
cow-pox  has  completed  its  progress,  its  vesicle,  like  any  other  inflamed  part,  will  become 
the  seat  of  a  small-pox  pustule,  or  the  whole  vesicle  will  become  purulent,  contrary  to 
its  legitimate  character.  In  the  first  case,  you  may  take  small-pox  matter  from  the  pus¬ 
tule,  which,  by  the  adhesive  inflammation,  will  remain  distinct  from,  though  seated  in 
part  of  the  vaccine  vesicle  ;  and  from  the  other  parts  of  the  vesicle  you  may  take  the  vac¬ 
cine  matter,  and  each  will  perpetuate  its  respective  morbid  poison.  If  the  whole  vesicle 
becomes  purulent  it  is  a  variolous  pustule,  and  will  inoculate  small-pox. 

“It  was  remarked  by  Dr.  Woodville  that  if  a  person  is  inoculated  with  small-pox  to¬ 
day,  and  three  or  four  days  after  is  reinoculated  with  the  same  morbid  poison,  though 
the  last  insertion  may  remain  a  smaller  pustule  than^the  first,  yet  both  inoculations  will 
arrive  at  their  height  at  the  same  time.  The  same  takes  place  in  cow-pox  ;  and  also,  if 
a  person  is  inoculated  to-day  with  cow-pox,  and  three  or  four  days  after  with  small-pox, 
or  to-day  with  small-pox  and  three  or  four  days  after  with  cow-pox,  the  two  insertions, 
though  the  last  may  remain  smaller  than  the  first,  will  maturate  and  scab  at  the  same 
time. 

“By  these  facts  it  appears,  first,  that  a  marked  kind  of  small-pox  may  be  perpetuated. 
If,  therefore,  the  cow-pox  is  a  marked  kind  of  small-pox,  there  can  be  no  reason  why  it 
should  not  have  been  perpetuated  with  its  true  character;  and  that  the  cow-pox  is  such, 
appears,  secondly,  by  its  not  being  interrupted  by,  and  not  interrupting  the  progress  of 
small-pox,  and  by  both  retaining  their  respective  laws  and  characters  at  the  same  time, 
whether  inoculated  separately  in  different  subjects,  or  the  same;  or  if  each  has  been  in¬ 
oculated  in  the  same  subject  at  different  times,  the  consequence  is  similar  to  the  inocu- 
tion  of  either  one,  at  different  times. 

“These  experiments  have  been  repeated  so  often,  as  to  leave  no  question  concerning 
the  law.  The  same  experiments  have  been  repeatedly  tried  with  small-pox  and  measles, 
and  also  with  cow-pox  and  each  of  the  others,  yet  these  interruptions  have  always  fol¬ 
lowed,  which  have  been  remarked  in  the  early  part  of  the  work. 

“  As,  therefore,  a  marked  variety  of  small-pox  is  capable  of  preserving  its  distinct 
character  under  inoculation,  there  seems  no  reason  why  the  cow-pox  should  not  be 
among  such  varieties ;  and  as  any  of  the  known  varieties  will  destroy  the  susceptibility 
to  the  disease  in  all  other  forms,  so  there  is  no  reason  why  cow-pox,  if  among  the  varie¬ 
ties,  should  not  do  the  same  ;  and  there  is  the  more  reason  to  expect  this,  because, 
contrary  to  any  morbid  poisons,  the  action  of  small-pox  and  cow-pox  are  maintained  at 
the  same  time  in  different  parts  of  the  constitution,  subject  respectively  to  similar  laws, 
whether  only  one  or  both  of  them  are  applied  in  any  variety  of  forms. 

“  It  may  be  said  that  small-pox  is  an  eruptive  disease,  whilst  cow-pox,  though  affecting 
the  constitution,  is  only  confined  in  its  local  action  to  a  single  part.  But  small-pox 
is  sometimes,  we  have  seen,  equally  confined  in  its  local  action,  and  principally  in  those 
cases  in  which  its  appearance  most  resembles  cow-pox.  It  is  not  less  certain  that  cow- 
pox,  on  some  occasions,  produces  secondary  eruptions.  Besides  the  cases  I  have  seen 
myself,  the  Rev.  Mr.  Holt  (Med,  and  Phys.  Journal )  gives  an  account  of  full  eruption 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


315 


of  vesicles,  which  had  the  same  properties  of  contagion  as  the  inoculated  part.  The 
Rev.  Mr.  Fermn  saw  a  few  scattered  in  different  parts.”  ( Adams  on  Morbid  Poison,  pp. 
398-401.) 

Dr.  Willan  found  “that  when  a  person  is  inoculated  with  vaccine  and 
variolous  matter  about  the  same  time,  (that  is,  not  exceeding  a  week,)  both 
inoculations  proved  effective,  for  the  vaccine  vesicle  proceeded  to  its  acme 
in  its  usual  number  of  days,  and  the  maturation  of  the  variolous  pustule 
was  attended  by  a  variolous  eruption  on  the  skin.”  (On  vaccine  Inocula¬ 
tion,  p.  1.) 

When  cow-pox  is  inserted  during  the  incubative  stage  of  the  casual 
small-pox,  while  the  small-pox  is  still  latent,  the  vaccine  vesicle  for  the 
most  part  does  not  advance,  or  advances  tardily  and  imperfectly.  There 
are  exceptions,  however,  to  this  rule,  and  cow-pox  and  casual  small  pox 
may  sometimes  be  seen  running  their  full  course  at  the  same  time.  In  no 
case,  however,  does  the  cow-pox  so  inserted  alter  or  modify  the  course  of 
the  small-pox.  When  the  variolous  and  vaccine  fluids  are  inserted  into  the 
arms  on  the  same  day,  each  disease  occasionally  proceeds,  preserving  its 
original  character.  At  other  times,  however,  they  mutually  restrain  and 
modify  each  other.  The  vaccine  vesicle  is  smaller  than  usual,  and  irregu¬ 
lar  in  its  progress,  while  the  variolous  pustules  which  follow  are  of  the 
kind  denominated  variolae  verrucosae,  vulgarly  swine-pock,  stone-pock, 
or  horn  pock  (  Willan  on  Vaccine  Inoculation ,  p.  5 )  ;  that  is  to  say,  they  are 
hard  and  shining,  surrounded  with  little  inflammation  and  they  suppurate 
imperfectly.  The  small  quantity  of  matter  they  contain  is  absorbed,  leav¬ 
ing  the  cuticle  horny  and  elevated  for  many  days  afterwards.  Upon  the 
extremities  the  eruption  does  not  pustulate  at  all,  but  is  minute  and  papu¬ 
lous,  and  terminates  by  desquamation.  It  will  be  found  in  most  cases  that 
even  though  the  eruption  be  modified  in  its  character,  there  is,  neverthe¬ 
less,  considerable  disturbance  of  the  general  system  under  the  joint  influ¬ 
ence  of  the  variolous  and  vaccine  poisons. 

Dr.  Woodville  has  said  that  if  the  cow-pox  matter  and  the  small-pox 
matter  be  both  inserted  in  the  same  arm  of  a  patient,  even  within  an  inch 
of  each  other,  so  that  on  the  ninth  day  the  same  efflorescence  becomes  com¬ 
mon  to  both  the  local  affections,  nevertheless  inoculating  from  the  cow-pox 
tumor  the  genuine  vaccine  disease  will  be  produced  ( Observations  on  the 
Cow-pox ,  p.  12) ;  but  if  the  inoculation  be  performed  with  a  mixture  of  the 
two  matters,  then  the  chance  is  equal  that  small  pox  or  cow-pox  will  be 
the  result,  or  the  varioloid  disease. 

When  the  insertion  of  the  vaccine  lymph  precedes  that  of  the  variolous 
by  a  period  not  exceeding  four  days,  both  diseases  advance  locally.  Some¬ 
times  an  eruption  of  small  pox  papulae  follows.  At  other  times  the  vario¬ 
lous  fever  is  slight  and  unaccompanied  by  eruption.  Under  these  circum¬ 
stances  matter  taken  from  the  primary  vesicles  shall  sometimes  communi¬ 
cate  cow-pox  and  small-pox  respectively,  but  more  commonly  the  variolous 
poison  predominates,  and  contaminates  the  lymph  of  the  vaccine  vesicle. 
It  was  ignorance  of  this  phenomenon,  in  the  mutual  action  of  the  vaccine 
and  variolous  poisons,  which  occasioned  Dr.  Woodville’s  mistakes  at  the 
small- pox  hospital  in  1799. 

Variolous  matter  inserted  into  the  arm  at  any  period  not  exceeding  a 
week  from  the  date  ot  vaccination  will  take  effect  and  be  followed  by  a 
pustule.  After  that  time  no  effect  is  produced. 

When  small-pox  inoculation  precedes  by  three  or  four  days  the  insertion  of 
vaccine  lymph,  the  vaccination  advances,  but  after  the  tenth  day  the  fluid 
in  the  vaccine  vesicle  becomes  purulent}  and  in  that  state  will  communi- 


316 


Spurious  Vaccination  :  Joseph  Jones,  M.  D. 


cate  small  pox.  (Willan  on  Vaccine  Inoculation,  p.  8 ;  also  Dr.  George 
Gregorie’s  valuable  article  on  Vaccination  in  the  Cyclopaedia  of  Practical 
Medicine.) 

Dr.  Denby,  whilst  admitting  that  the  period  of  incubation  of  variola 
may  be  somewhat  undefined,  as  in  the  case  of  other  animal  poisons,  con¬ 
cludes  that,  nevertheless,  from  experiments,  a  fair  conclusion  may  be  formed 
as  to  the  usual  period  of  this  incubation,  when  prophylaxis  may  be  in¬ 
duced.  And  trom  these  Dr.  Denby  judged  that,  if  on  the  third  day,  before 
the  onset  of  erethism,  rigor,  and  headache,  perfect  lymph  be  inserted, 
prophylaxis  is  almost  certain,  assuming  three  or  four  days  for  the  premoni¬ 
tory  symptoms  before  the  variolous  point  or  papula  appears.  The  vaccine 
vesicle  will  then  be  eight  or  nine  days  old,  the  areola  will  be  becoming 
indurated,  and  erethism  will  exist.  Dr.  Denby  considers  that  in  this 
fever  against  fever,  the  essence  of  prophylaxis  really  exists.  If  under  this 
influence  the  variolous  papula  proceeds,  it  will  resemble  umbilicated  vari¬ 
cella  or  horn-pock.  If  the  vaccine  be  used  two  days  later,  especially  if 
there  be  bronchial  or  pulmonary  symptoms  present,  it  will  be  useless.  The 
papula  may  be  just  apparent,  but  it  will  be  blighted.  There  are,  of 
course,  exceptions  to  this  rule.  A  woman  was  delivered,  says  Dr.  Hennen, 
while  suffering  from  confluent  variola;  the  infant  was  vaccinated  a  few 
hours  after  birth.  The  mother  died  on  the  eleventh  day  ;  the  infant  had 
true  vaccine  and  lived.  Med.  Times ,  October  25,  1851.j 

In  an  analagous  case,  reported  by  Mr.  T.  C.  Beatty,  of  Durham,  the 
child  delivered  from  a  mother  in  whom  the  variolous  pustules  made  their  ap¬ 
pearance  during  labor,  was  not  vaccinated  until  the  morning  of  the  fourth 
day  after  its  birth.  True  vaccine  was  the  result ;  and  yet,  on  the  eighth 
day  after  she  was  vaccinated,  when  the  vesicles  were  fully  matured,  the 
little  patient  was  very  ill,  and  showed  signs  of  eruption  under  the  skin, 
which  proved  to  be  confluent  small-pox,  of  which  the  little  creature  died 
four  days  after.  (London  Lancet,  1852.) 

Dr.  Robert  Fowler,  of  the  Loughborough  Dispensary,  and  Mr.  Robert 
Tod,  of  Gilmore  Place,  Edinburgh,  (London  Lancet,  1852) ;  MM.  Herard 
and  Bousquet,  (L’Union  Medicale,  Nos.  108,  109,  110,  Bulletin  de  Thera- 
peutique,  tome  35,  pp.  342-52),  and  others,  have  recorded  cases  proving  the 
possibility  of  the  simultaneous  existence  of  small-pox  and  the  vaccine  dis¬ 
ease,  and  confirming  the  correctness  of  the  conclusions  of  Jenner  and  the 
older  observers. 

M.  Bousquet  goes  so  far  as  to  deny  that  the  two  eruptions,  variola  and 
vaccinia,  exert  any  reciprocal  reaction,  and  the  nearer  they  appear  to¬ 
gether,  the  more  independent  are  they  of  each  other.  Suppose  for  example, 
that  they  could  appear  at  the  same  hour,  then  each  would  pursue  its  or¬ 
dinary  course,  just  as  if  the  other  were  not  present.  But  supposing  the 
one  eruption  appears  after  the  other,  all  will  depend  upon  the  space  of 
time  separating  them.  If  this  be  only  some  hours,  or  even  two  or  three 
days,  all  passes  on  as  just  stated.  The  case  is  different  when  one  of  these 
eruptions  is  greatly  in  advance  of  the  other.  If  this  is  not  to  such  an 
extent  as  to  exclude,  the  eruptions  progress  together,  but  nob  in  parallel. 
The  most  advanced  always  keeps  its  advantage,  and  finishes  at  its  ordinary 
epoch,  without  having  undergone  any  change  inform  or  duration.  The 
other  follows  it  at  a  distance,  but  after  the  variolous  capacity  of  the  sub¬ 
ject  has  become  exhausted  by  the  first,  the  second  dies  away. 

In  these  influences,  M.  Bousquet  considers  that  there,  is  nothing  direct, 
active  or  special;  they  are  the  consequences  of  the  faculty  possessed  by  the 
eruptions  of  supplying  Or  substituting  each  other.  The  vaccinia  dobs  not 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


317 


arrest  the  variola,  but  it  is  the  variola  that  stops  short  in  the  face  of  the 
vaccinia  :  and,  conversely,  variola  does  not  cut  short  the  course  of  vac¬ 
cinia,  but  this  last  interrupts  its  own  course  in  presence  of  the  variola.  It 
is  the  right  of  precedence,  and  the  more  widely  the  two  eruptions  are 
separated,  the  more  readily  do  they  exclude  each  other,  while  the  nearer 
they  are  together,  the  more  independently  do  they  proceed.  Considered 
in  themselves,  the  vaccine  and  variolous  virus  are  so  little  capable  of  des¬ 
troying  each  other’s  energy,  that  if  they  are  mixed  together,  and  inocula¬ 
tion  performed  with  the  mixture,  M.  Bousquet  affirms  that  two  perfectly 
distinct  eruptions  may  be  produced. 

Considered  as  regards  their  effects,  therefore,  according  to  this  view,  it 
cannot  be  said  that  vaccinia  cures  variola,  or  even,  rigorously  speaking, 
prevents  it.  It  takes  its  place,  stands  in  its  stead,  and  is  neither  more  nor 
less  than  a  substitution.  Thus,  so  far  from  explaining  the  operation  of 
vaccinia  by  the  supposed  opposition  it  offers  to  variola,  we  would  rather  do 
so  by  the  analogy  and  reciprocal  action  of  the  two  diseases.  (Bulletin  de 
Therapeutique,  tome  35,  pp.  342-52  ;  also,  the  British  and  Foreign  Medico- 
Chirurgical  Beview,  April,  1849.) 

From  the  facts  recorded  in  this  section,  we  deduce  the  practical  conclu¬ 
sions  : 

First — That  vaccine  matter  derived  from  the  patients  of  small-pox  hos¬ 
pitals,  or  from  those  in  civil  or  military  practice  who  have  been  exposed  to 
the  contagion  of  small-pox,  should  never  be  used  for  the  propagation  of 
the  vaccine  disease. 

Second — The  vaccine  disease  is  not  a  distinct  disease  from  small-pox,  but 
a  variety  or  modified  form  of  the  variolous  affection. 


SECTION  VI. — DBIED  VACCINE  LYMPH  OB  SCaBS,  FBOM  PA¬ 
TIENTS  WHO  HAD  SUFFEBED  WITH  EBYSIPELAS  DUBING 
THE  PBOGBESS  OF  THE  VACCINE  DISEASE,  OB  WHOSE 
SYSTEMS  WEBE  IN  A  DEPBESSED  STATE  FBOM  IMPBOPEB 
DIET,  BAD  VENTILATION,  AND  THE  EXHALATIONS  FBOM 
TYPHOID  FEVEB,  EBYSIPELAS,  HOSPITAL  GANGBENE, 
PYAEMIA,  AND  OFFENSIVE  SUPPUBATING  WOUNDS— DB 
WM.  GEBDNEB,  OF  GBEENE  COUNTY,  TENN.,  ON  THE  EE- 
LATIONS  OF  EBYSIPELAS  TO  VACCINATION— CASES  OF 
EBYSIPELAS  FOLLOWING  VACCINATION— VIEWS  OF  DB. 
PAUL  F.  EVE,  ON  THE  POSSIBILITY  OF  INOCULATING  EBY¬ 
SIPELAS  BY  VACCINATION— DB.  J.  C.  NOTT,  OF  MOBILE, 
ALA.,  ON  EBYSIPELAS— BEPOBT  OF  DB.  J.  F.  BELL,  OF  VIE- 
GINIA— BEPOBTS  OF  SUBGEON  HUNTEB  McGUIBE  OF  VIR¬ 
GINIA,  AND  OF  OTHEB  PHYSICIANS. 

In  several  instances  during  the  revolution  death  resulted  from  phleg¬ 
monous  erysipelas  following  vaccination  in  apparently  healthy  patients, 
in  both  civil  and  military  practice. 

It  was  believed  that  in  some  cases  the  poison  of  erysipelas  was  con¬ 
veyed  along  with  the  vaccine  virus; 


318 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


In  one  instance  which  came  to  my  knowledge,  the  lives  of  several  negro 
women  and  children  were  destroyed  by  erysipelas  excited  by  vaccine 
matter  taken  from  the  same  scab,  and  a  stont  healthy  white  man  who  was 
vaccinated  with  the  same  matter,  and  by  the  same  physician  who  vae- 
cinnaated  the  negro  (on  a  neighboring  plantation),  was  extremely  ill  from 
the  effects  of  the  poisonous  matter,  and  barely  escaped  with  the  loss  of  a 
large  portion  of  the  muscles  of  the  arm. 

I  was  informed  upon  good  authority  that  the  matter  caused  the  death  of 
a  pregnant  negro  woman,  and  of  another  uegress  and  her  young  infant,  of 
some  week  or  ten  days  of  age,  at  the  time  of  the  inoculation  of  the  vaccine 
virus. 

The  following  observations  relating  to  erysipelas  following  vaccina¬ 
tion,  were  placed  in  my  hands,  by  Dr.  Frank  A.  Ramsay,  of  Memphis, 
Tennessee : 

COMMUNICABILITY  OF  SYPHILIS  BY  VACCINATION.  BY  WILLIAM  GERDNER, 
M.  D.,  OF  GREEN  COUNTY,  TENNESSEE. 

I  notice  in  the  Medical  and  Surgical  Monthly,  June,  1866,  an  article  taken  from  the 
Richmond  Medical  Journal,  June,  1866,  by  William  Fuqua,  M.  D.,  Appomatox  County, 
Virginia,  on  the  communicability  of  syphilis  by  vaccination. 

About  the  same  time  referred  to  by  Dr.  Fuqua,  I  had  numerous  cases  of  vaccination,  in 
the  district  of  my  practice,  presenting  abnormal  features.  The  people  believed  it  to  re¬ 
sult  from  syphilis,  and  called  the  exhibitions  by  that  name.  I  made  close  scrutiny  of  the 
cases  occurring  under  my  observation,  and  concluded  that  they  were  not  syphilitic  in 
origin  or  manifestation.  I  regarded  them  as  erysipelas,  presenting  the  form  called  phleg¬ 
monous,  for  which  opinion  I  thought  I  had  reasons.  Many  cases  assumed  the  form  of 
common  erysipelas,  invading  limited  portions  of  the  arm,  and  in  some  few  cases  the 
whole  surface  of  the  vaccinated  limb  was  affected. 

The  proper  distinction  for  the  practical  physician  of  erysipelas,  is  superficial  and  deep- 
seated — ordinary  or  common  erysipelas afifectiug  the  cuticle  proper — deep  seated  or  phleg¬ 
monous  erysipelas  involving  the  tissues,  particularly  the  cellular.  At  present  the  cause 
of  the  difference  is  inexplicable — why  in  one  case  serum,  and  in  the  other  lymph  is  poured 
out,  remains  a  question,  while  the  fact  exists.  Each  distinct  inflammation  has  its  habits. 

As  far  as  my  knowledge  extends,  tbe  records  of  medicine  do  not  afford 
any  very  large  collection  of  cases  of  erysipelas  supervening  upon  vaccina¬ 
tion.  The  following  are  the  most  important  cases  of  the  apparent  excitation 
of  erysipelas  by  vaccination,  which  were  noted  in  the  works  and  journals 
consulted  during  these  researches  : 

Diffuse  Cellular  Inflammation  following  Vaccination. — The  first  was  that  of  a  female  child, 
aged  five  years,  who  had  been  vaccinated  by  a  respectable  practitioner  in  Dublin.  This 
child  was  brought  to  the  physician  who  reports  these  cases,  about  three  weeks  after  it 
had  been  inoculated.  The  arm  was  then  greatly  swollen,  the  swelling  extending  to  the 
hand ;  the  integuments  of  the  upper  arm  were  of  a  dusky  leaden  hue,  and  a  large  black 
slough  occupied  the  situation  of  the  usual  crust  of  the  vaccine  vesicle.  The  child’s  pulse 
was  weak  and  slow,  not  exceeding  sixty-four.  The  extremities  were  cold,  tongue  dry 
and  coated.  There  were  extensive  sloughing  and  hemorrhage  from  the  mucus  membrane 
of  the  mouth.  The  integuments  of  the  cheeks  adjoining  the  commissure  of  the  lips  were 
of  a  livid  hue.  The  respiration  was  very  much  hurried,  but  no  pliysical  sign  of  disease 
could  be  detected  in  the  chest. 

The  child’s  parents  stated  that  these  formidable  symptoms  first  presented  themselves, 
between  the  ninth  and  twelfth  day  from  that  on  which  it  had  been  vaccinated.  The 
practitioner  who  inoculated  the  child  affirmed  that  up  to  that  period,  the  vaccine  vesicle 
ran  a  healthy  course  and  that  he  had  vaccinated  other  children  with  the  same  lymph  in 
whom  the  course  of  the  vesicle  was  perfectly  regular.  This  child  was  of  a  delicate  con¬ 
stitution,  having  suffered  with  attacks  of  scrofulous  ophthalmia,  pneumonia,  and  bron¬ 
chitis.  Its  health  was  said  to  be  good,  at  the  time  it  was  inoculated.  Complete  recovery, 
though  very  slow,  was  effected  in  this  case  by  the  use  of  mild  tonics  and  stimulants. 

The  second  case”was  that  of  a  male  child,  aged  eighteen  mouths,  who  was  also  vac¬ 
cinated  by  a  physician  of  Dublin.  About  the  twelfth  day  from  the  period  on  which  it 
was  vaccinated,  the  arm  was  attacked  with  severe  inflammation  of  the  erysipelatous 
character,  the  vaccine  vesicle  having,  up  to  that  day,  according  to  the  statements  of  the 
parents,  run  a  regular  course.  On  the  sixteenth  day,  a  dark  slough,  as  large  as  a  shilling 
occupied  the  situation  of  the  vesicle;  the  entire  extremity  was  immensely  swollen;  the 


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319 


integuments  of  the  upper  arm  were  of  erysipelatous  redness,  and  such  of  them  as  were 
in  the  immediate  neighborhood  of  the  slough  were  quite  livid.  The  attending  fever  was 
of  the  inflammatory  type,  the  skin  being  hot,  tongue  furred,  pulse  rapid  and  full,  and 
the  thirst  great.  Until  the  fever  was  subdued  by  cooling  and  alterative  medicine,  and 
the  local  inflammation  relieved  by  the  application  of  poultices  and  formentations,  the 
sloughing  spread  with  the  most  alarming  rapidity.  After  the  sloughs  had  separated,  and 
the  progress  of  the  gangrene  arrested,  a  large  and  deep  ulcer  remained  with  undermined 
edges,  at  the  bottom  of  which  the  muscles  of  the  arm  could  be  distinctly  observed  ;  so 
extensive  was  this  ulcer,  that  it  was  not  healed  for  three  mouths,  though  the  case  pro¬ 
gressed  most  favorably  in  every  respect.” — Dublin  Journal  of  Medical  Sciences,  1844. 

Dr.  Greene  reported  to  the  Boston  Society  for  Medical  Improvement,  a 
fatal  case  of  erysipelas,  following  re-vaccination,  which  occurred  in 
January,  1846. 

The  patient,  a  gentleman  sixty-four  years  of  age,  had  been  vaccinated  twenty  years 
before,  and  re-vaccinated,  though  without  success,  two  or  three  times  since.  On  Friday, 
the  day  after  the  re-vaccination  by  Dr.  Greene,  he  was  seized  with  chills,  nausea,  and  a 
sense  of  general  uneasiness;  and,  at  the  same  time,  inflammation  commenced  in  the  arm, 
attended  by  heat,  redness,  and  pain.  He  slept  none  on  the  following  night,  and  on  the 
next  night  was  attacked  with  vomiting  and  purging.  The  symptoms  from  this  time  did 
not  become  materially  worse,  however,  till  the  following  Wednesday,  when  he  complained 
of  pain  just  below  the  elbow  ;  and  on  Thursday,  a  small  patch  of  erysipelas  was  discov¬ 
ered  at  this  point,  which  gradually  extended  over  the  arm  and  chest  of  the  affected  side, 
the  infiltration  of  the  cellular  tissue,  keeping  about  two  inches  ahead  of  the  redness.  He 
died  at  ten  on  Friday  evening,  a  little  more  than  eight  days  from  the  time  of  re-vaccina- 
tion,  the  erysipelas  having  extended  to  within  two  inches  of  the  sternum.  In  regard  to 
the  quality  of  the  matter  introduced,  Dr.  Greene  remarked  that  it  was  taken  on  the  eighth 
day  from  a  perfectly  formed  vesicle,  on  the  arm  of  a  perfectly  healthy  infant,  born  of 
healthy  parents  ;  that  one  of  his  own  children  had  been  vaccinated  with  the  same  matter, 
and  also  another  person,  in  both  which  cases,  the  symptoms  and  appearances  were 
slight. 

It  is  said  that  in  1849  and  1850,  erysipelas  so  frequently  followed  vac¬ 
cination  in  Boston,  and  the  result  was  so  often  fatal,  that  many  physicians 
refused  to  vaccinate,  except  when  it  was  absolutely  necessary,  and  almost 
entirely  abandoned  re- vaccination.  Cases  were  reported  to  the  Boston 
Society  for  Medical  Improvement,  by  Drs.  J.  B.  S.  Jackson,  Cabot,  Bige¬ 
low,  Homans,  Putnam  and  Channiug.  From  the  transactions  of  this  so¬ 
ciety  we  select  the  following  cases  : 

Case  Reported  by  Dr.  Cabot. — This  being  a  case  rather  of  diffuse  cellular  inflammation 
than  common  erysipelas.  The  patient  was  a  gentleman,  sixty-nine  years  of  age,  who 
having  been  exposed  to  varioloid,  was  re-vacciuated  in  two  places  on  the  third  of  April. 
On  the  second  day,  two  vesicles  had  formed  about  the  size  of  a  small  pin’s  head,  and 
there  was  pain  in  the  axilla,  with  pain  and  soreness  under  the  pectoral  muscles.  In 
about  two  weeks  the  inflammation  had  extended  to  the  hand,  and  in  the  course  of  the 
third  week;  an  opening  was  made  about  the  elbow,  from  which  a  considerable  quantity 
of  sero-purulent  fluid  was  discharged  ;  the  back  of  the  hand  beiug  opened  down  to  the 
fascia  a  few  days  afterwards.  From  the  shoulder  the  erysipelas  extended  over  the  whole 
back,  down  the  right  arm  to  the  elbow,  and  somewhat  over  the  abdomen  from  each  side  ; 
also  across  the  front  of  the  chest,  nearly  to  the  right  shoulder.  The  whole  duration  of 
the  erysipelas  in  an  active  form  was  about  seven  or  eight  weeks ;  neither  the  hand  nor 
lower  extremities  were  affected;  the  areola  about  the  vaccine  points  subsided,  but  sub¬ 
sequently  the  surface  was  attacked  with  the  disease.  The  suppuration  about  the  left 
shoulder  and  down  the  upper  extremity  had  been  very  extensive ;  the  pectoaal  muscle 
was  separated  from  the  parietes  of  the  chest,  and  the  skin  of  the  forearm  was  so  de¬ 
tached  from  the  subjacent  parts  that  fluids  thrown  in  at  the  elbow  would  pass  out  at  the 
back  of  the  hand;  very  numerous  openings  have  been  made  about  the  elbow  and  shoulder 
for  the  discharge  of  pus.  For  about  two  months  the  patient  was  confined  to  his  bed, 
and  convalescence  was  tedious.  The  prostration  was  not  so  great  as  would  have  been 
expected  in  such  a  case  ;  the  pulse  not  rising  above  ninety  during  the  active  stage  of  the 
inflammation  ;  there  was,  however,  some  delirium,  with  chills,  headaches  and  pain  in  the 
back.  No  suppuration  occurred,  except  in  the  parts  above  alluded  to. 

Case  Reported  by  Dr.  J.  Bigelow. — This  patient  was  a  gentleman,  about  thirty  years  of 
age,  and  having  been  exposed  to  small-pox,  was  re-vaccinated  with  several  others,  from 
the  same  virus.  Two  days  afterwards,  an  erysipelatous  spot,  of  the  size  of  a  dollar,  was 
discovered  around  the  point  of  vaccination.  This  spread  rapidly  in  every  direction,  and 
at  the  end  of  five  days,  had  occupied  the  whole  arm  from  the  shoulder  to  the  elbow.  At 


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Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


this  time,  several  dark  spots  appeared  upon  the  inside  the  arm,  which  in  two  days  were 
perfectly  gangrenous,  so  that  an  incision  was  made  five  inches  in  length,  without  pain. 
The  slough  was  apparently  confined  to  the  skin  and  cellular  substance,  inasmuch  as  the 
muscular  power  was  at  no  time  lost.  Meanwhile  the  pulse  was  quick,  and  the  skin  hot, 
with  prostration,  headache  and  delirum.  In  another  week,  the  erysipelas  had  extended 
to  the  whole  trunk,  half  way  down  the  thigh,  and  to  the  wrist  of  the  affected  arm  ;  the 
patient  being  much  of  the  time  delirious,  or  somnolent,  and  with  a  pulse  of  120.  During 
the  third  week,  the  symptoms  were  greatly  aggravated,  and  the  cerebral  affection  in¬ 
creased  ;  there  was  also  a  retention  of  urine,  and  the  catheter  was  required  for  a  fort¬ 
night.  During  this  time,  however,  the  slough  gradually  separated,  leavinga  large,  deep 
ulger.  The  patient  became  convalescent  at  the  end  of  a  month,  and  slowly  recovered  ; 
the  ulcer  requiring  another  mouth  or  more  to  cicatrize.  No  other  person,  who  was  vac¬ 
cinated  with  the  same  virus,  had  any  unusual  symptoms  ;  but  a  lady  of  the  family, 
about  seven  weeks  after  the  vaccination,  was  attacked  with  inflammation  of  the  fauces 
and  tonsils,  followed  by  protratmn  and  delirum,  and  died  in  a  week  ;  during  her  sickness 
a  livid  spot,  about  two  inches  in  diameter,  appeared  over  the  upper  part  of  the  sternum, 
but  this  disappeared  before  death. 

In  another  case  reported  by  Dr.  Bigelow  ;  a  healthy  child  about  five  months  old,  was 
vaccinated,  and  the  vesicle  went  on  well  until  the  ninth  day,  when  the  arm  became 
erysipelatous,  the  inflammation  rapidly  spreading  over  the  whole  trunk  ;  and  the  child 
died  in  a  few  days.  On  the  eighth  day  of  the  vesicle,  the  day  before  the  appearance  of 
the  erysipelas,  matter  was  taken  with  which  three  others  were  vaccinated,  and  these 
patients  had  perfect  vesicles  without  any  anomalous  symptoms 

Case  Reported  by  Dr.  Homans. — The  patient  was  a  healthy  infant,  about  tbree  weeks 
old.  On  the  eighth  day,  the  vesicle  appeared  well,  and  matter  was  taken  with  which 
other  children  were  vaccinated,  the  result  being  in  every  case  successful.  On  the  tenth 
day,  erysipelas  appeared  below  the  elbow,  and  extended  into  the  axilla  ;  the  swelling 
and  redness  very  defined,  and  the  inflammation  spread  rather  more  rapidly  than  is  usual 
in  the  adult.  Vomiting  and  diarrhoea  came  on,  and  lasted  some  days  ;  the  pulse  was  too 
quick  to  be  counted.  The  head  and  abdomen  then  became  affected,  and  on  the  ninth 
day  from  the  invasion  of  the  olisease,  the  scrotum  and  penis  were  greatly  swollen  ;  these 
last  were  punctured  with  much  relief,  but  a  deep  sloughing  of  the  scrotum  took  place, 
one  and  a  half  inches  in  diameter,  and  nearly  exposing  the  testicles.  The  'extremities 
were  next  affected,  but  in  the  mean  time  the  child  began  to  improve,  and  the  pulse  had 
fallen  to  120.  On  the  subsidence  of  the  disease,  abcesses  formed  upon  the  body  and 
limbs  beneath  the  surface,  and  about  the  left  hip,  one  that  was  quite  large  and  deep. 
This  last,  is  the  only  one  that  remains  open,  and  the  child  is  fairly  convalescent,  after  a 
sickness  ol  about  three  months. 

Dr.  Charming  mentioned  a  case  of  erysipelas  after  vaccination  in  which 
the  shoulder,  axilla  and  pectoral  muscles  were  involved.  (The  American 
Journal  of  Medical  Sciences,  October,  1850 — pp.  318-321.) 

Dr.  Charles  E.  Buckingham,  Physician  to  the  Boston  House  of  Industry, 
has  also  published  an  interesting  case  of  “Constitutional  Irritation  follow¬ 
ing  Vaccination,”  from  which  we  make  the  following  abstract: 

B - ,  a  farmer,  twenty-five  years  of  age,  of  previous  robust  health,  vaccinated  on 

Thursday,  August  28,  1849. 

September  first,  he  took  an  emetic,  and  on  the  second  a  cathartic  dose.fl'Both  operated 
freely.  Dr.  Buckingham  was  first  called  to  him  at  nine  P.  M.,  September  3.  At  this 
time  the  patient  presented  the  following  conditions  :  Complete  anorexia  ;  great  thirst  * 
headache;  sleeplessness;  pain  in  back;  eyes  and  hearing  normal ;  urine  free  ;  pulse  150  full 
and  strong;  decubitus  dorsal.  His  late  vaccination  was  not  known  at  this  time.  Got  a 
saline  mixture,  consisting  principally  of  bicarbonate  of  soda  and  chlorate  of  potassa. 

Fourth. — Febrile  action  less ;  has  pain  in  calf  of  right  leg ;  no  tenderness,  redness 
swelling  or  heat. 

Ninth.— Pulse,  84  ;  appetite  good.  No  sleep  last  night  on  account  of  the  pain  in  the 
calf,  and  in  the  sole  of  the  right  foot ;  has  had  a  sinapism  to  the  foot,  with  partial 
relief;  no  dejections  for  twenty-four  hours;  whole  of  right  calf  swollen  ;  a  circum¬ 
scribed  red  spot  one  and  a  half  inches  below  head  of  right  fibula,  covering  about  two 
inches.^ 

Tenth.— Patient  was  seen,  in  consultation,  by  Dr.  H.  G.  Clark.  Kedness  more  diffused; 
leg  much  swollen,  and  cedematous  from  knee  to  heel ;  pain  confined  to  spot  of  yesterday, 
which  is,  for  the  first  time,  tender;  no  headache  or  thirst ;  eyes  and  hearing  normal ; 
neither  delirum  nor  sighing ;  no  appetite  ;  tongue  red  at  its  top,  and  in  other  parts  cov¬ 
ered  with  a  thick  creamy  paste  ;  pharynx  the  same  ;  pulse,  88,  full. 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


321 


Thirteenth,  9  a.  m. — Pulse,  100,  full  and  soft ;  dejection.  Attention  was  called  to  a  hard, 
red,  circumscribed  swelling  on  the  left  forearm,  similar  to  the  others  ;  in  examining  which, 
found  the  remains  of  an  irregular  vaccination,  of  which  Dr.  Buckingham  first  learned 
the  date  as  given  above. 

Sixteenth.— Swelling  of  right  leg  decidedly  less ;  that  of  the  left  leg  hard,  red,  and  ex¬ 
cessively  tender.  The  right  elbow  was  red  and  swollen.  The  right  eye  red,  swollen  and 
painful  about  the  orbit ;  no  conjunctival  redness ;  tears  trickling  over  face;  pulse  120, 
full,  soft,  dicrotic  ;  respiration  slow  aud  distinct,  with  occasional  sighing;  no  delirium; 
tongue  perfectly  steady,  when  protruded;  face  somewhat  livid;  no  dejection  for  two 
days,  except  from  enemata. 

Eighteenth. — Had  a  good  night;  pulse  112;  respiration  16;  nose  much  swollen,  dusky, 
red  and  painful ;  about  a  dozen  papules,  hard,  red  and  shot-like,  scattered  over  forehead, 
face,  back  and  legs ;  no  glandular  enlargement.  12  M.,  a  few  more  papules  on  abdomen ; 
the  others  are  becoming  pustular,  and  a  few  are  umbilicated. 

Nineteenth,  8:30  a.m. — Two  dejections,  with  urine;  tongue  dry,  black  and  cracked; 
redness  and  swelling  of  whole  upper  face  ;  papules  increasing  in  number,  and  pustules  in 
size;  a  few  of  them  umbilicated;  no  glandular  enlargement. 

Twentieth,  10  a.  M,— Pulse  120,  more  firm,  but  not  so  full;  respiration  32,  labored,  no 
rales  ;  numerous  black,  pasty  dejections  ;  took  dose  of  brandy  in  the  night;  restless,  and 
occasionally  wandering  ;  easily  aroused,  and  speaks  sensibly,  but  soon  falls  asleep  again ; 
pustules  increasing  in  size  and  number,  some  of  them  as  large  as  good-sized  peas;  knuckles 
of  right  hand  swollen ;  both  sides  of  face  red,  swollen  and  cedematous ;  right  leg  of 
normal  size,  and  appears  well ;  left  leg  the  same,  with  the  exception  of  slight  tender¬ 
ness  ;  swelling  of  left  forearm  soft  and  fluctuating ;  no  glandular  enlargement,  nor  mark 
of  absorbents.  9  P.  M.,  constantly  delirius ;  unable  to  drink;  frequent  involuntary  de¬ 
jections  and  urine;  hands  tremble,  pulse  134,  feeble;  respiration  36,  noisy  and  husky; 
sounds  aud  impulse  of  heart  normal ;  many  of  the  pustules  drying  ;  scab  of  vaccination 
came  off  arm  ;  erythema  and  cedema  of  scalp. 

Twenty-first,  10  a.  m. — Delirious  all  night ;  takes  nothing ;  insensible ;  no  dejections  ; 
pulse,  134,  soft,  and  moderately  full ;  respiration  varies  from  30  to  40,  occasionally  like 
that  in  hydrophobic  paroxy&m  ;  heart’s  impulse  strong ;  first  sound  loud,  second  sound 
scarcely  perceptible. 

5:30  p.  M. — Died.  The  body  was  removed  early  next  day.  No  autopsy  allowed.” 

As  far  as  Dr.  Buckingham  could  learn,  there  had  been  no  sick  animal  on  his  farm, 
aud  so  far  as  known,  the  patient  had  had  no  communication  with  any  such,  nor  had 
he  any  occasion  to  handle  hides. — The  American  Journal  of  the  Medical  Science,  July, 
1850,  pp.  96-99. 

Many  of  sucli  unfortunate  accidents  attending  vaccination,  may  be  re¬ 
ferred  to  the  peculiarities  of  individual  constitution,  upon  some  condition 
of  ill-health  at  tke  time  of  vaccination,  upon  the  mode  of  life  pursued  dur¬ 
ing  the  progress  of  tke  vaccine  disease,  or  upon  some  circumstance  suck  as 
is  known  to  impart  a  severe  character  or  a  fatal  tendency  to  other  affec¬ 
tions.  Thus,  it  was  said,  that  in  the  case  of  Sir  Culling  Eardley,  who 
died  from  tke  effects  of  vaccination,  liis  health  at  the  time  of  the  operation 
was  not  in  completely  satisfactory  condition ;  and  in  another  case  recorded 
by  Mr.  Wells,  where  death  followed  re- vaccination,  that,  on  a  previous 
vaccination,  an  unusual  idiosyncrasy  was  manifested  by  the  occurrence  of 
a  prostration  almost  bordering  on  death. 

At  certain  times  the  development  of  erysipelas  after  vaccination  may  be 
traced  to  the  operation  of  the  same  cause  which  occasions  this  affection 
after  surgical  operations  of  any  kind.  Thus  in  October,  1859,  erysipelas 
followed  vaccination  in  a  few  cases  at  Parkhurst  on  the  Isle  of  Wight ;  and 
in  one  of  these  cases  sloughing  occurred  to  such  an  extent  as  to  render 
necessary  amputation  at  the  shoulder  joints.  At  that  time,  however,  there 
was  a  general  cause  of  ill-health  in  operation,  for  both  typhoid  fever  and 
erysipelas  were  prevailing  at  Newport,  and  several  cases  had  occurred  at 
the  Barracks.  It  is  well  known  to  every  surgeon,  that  at  such  times  all 
surgical  operations,  even  the  most  trifling,  are  dangerous. 

A  similar  event  on  a  large  scale  occurred  in  the  French  army  in  1858 
( Rapport  sur  les  Vaccination  en  France,  pour  1860  p.  21  j.  On  the  twenty- 
ninth  of  June,  1858,  several  men  were  admitted  into  the  hospital  with  en¬ 
gorgement  of  the  axillary  glands,  phlegmonous  erysipelas  of  the  arm,  etc., 


322 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


as  the  result  of  a  vacciuation  effected  on  the  twenty-first.  Sixty  men  were 
vaccinated  with  every  precaution  and  unexceptionable  lymph.  The  next 
day  one  of  them  was  attacked  with  phlegmonous  inflammation  of  the  arm, 
complicated  with  typhoid  fever,  the  origin  of  which  was  without  doubt 
prior  to  the  vaccination.  Three  days  later  another  soldier  was  similarly 
attacked,  and  the  fourth  day  seven  more,  but  without  the  typhoid  fever. 

M.  Larrey,  who  was  sent  to  inquire  into  the  affair,  noted  amongst  its 
causes,  first  of  all  a  very  high  atmospheric  temperature,  and,  secondly,  an 
unfavorable  medical  constitution.  Erysipelas  was  prevalent  in  the  town 
of  Florence,  where  this  accident  happened,  as  well  as  in  the  hospital,  and 
the  men  had,  moreover,  undergone  an  unusual  amount  of  fatigue  on  ac¬ 
count  of  an  approaching  inspection  of  the  troops.  It  is  evident  that  the 
mere  vaccination  was  not  in  fault,  since,  during  four  years,  more  than  12,- 
000  soldiers  from  the  garrison  of  Paris  had  been  re- vaccinated  without  any 
serious  accident  occurring. 

Dr.  Tymann  has  collected  iuto  a  table  a  large  number  of  instances  in 
which  erysipelas  or  troublesome  ulcerations  have  followed  vaccination  in 
the  practice  of  several  British  and  American  surgeons.  (American  Medi¬ 
cal  Series,  v.  4,  p.  134.)  The  greater  number  were  in  children  ;  but  then  it 
is  to  be  recollected  that  vaccination  is  mostly  performed  upon  children. 
Of  the  six  adults,  two  were  between  sixty  and  seventy  years  of  age,  one 
was  thirty,  one  was  twenty-five,  and  the  seventh  eighteen  years  old.  Seven 
of  the  cases  proved  fatal,  being  attacked  with  erysipelas  on  the  ninth  day 
in  three  instances;  on  the  tenth  in  one;  on  the  eighth  in  one;  on  the  sev¬ 
enth  in  one ,  and  in  one  case  the  time  of  attack  was  not  specified.  In  some 
of  the  other  cases  it  occurred  on  the  second,  third  or  fourth  days.  The 
season  of  the  year  in  which  these  cases  occurred  is  deserving  of  notice. 
Excluding  some  cases  of  tendency  to  troublesome  ulceration  during  the 
prevalence  of  a  cold  northeast  wind  in  the  .month  of  May,  only  three  ot 
the  whole  twelve  cases  or  groups  of  cases  collected  were  observed  during 
the  warmer  months  of  the  year.  With  regard  to  the  cases  in  the  month  of 
May,  it  is  stated  that  the  same  tendency  to  troublesome  ulceration  declared 
itself  also  in  persons  who  were  at  the  same  time  inoculated  for  small-pox. 

In  one  case  of  erysipelas  followed  by  sloughing  and  necessitating  ampu¬ 
tation,  related  by  Mr.  Chartres,  it  is  noted  again  that  an  epidemic  tendency 
to  unhealthy  inflammation  was  observed  in  all  cases  then  in  the  hospital, 
so  that  it  became  necessary  to  avoid  every  surgical  operation ;  and  even 
the  punishment  of  the  soldiers  by  flogging  was  suspended  on  account  of 
the  erysipelatous  inflammation,  which  occurred  whenever  the  cutaneous 
surface  was  injured. 

In  some  cases,  however,  the  occurrence  of  erysipelas  may  be  clearly  the 
fault  of  the  operator,  who  uses  lymph  taken  from  a  pock  too  far  advauned , 
or  lymph  which  has  been  present  in  the  fluid  state  so  long  as  to  permit  of  its 
decomposition ,  or  who  may  have  taken  it  from  a subject  recently  Mistered. 

.An  instance  is  recorded  of  nine  persons  vaccinated  in  the  year  1800  with 
virus  of  a  purulent  appearance,  taken  from  a  vesicle  at  a  very  late  period 
of  its  course;  extensive  erysipelas  resulted,  followed  by  ulceration,  and  in 
some  of  the  instances  by  a  tendency  to  gangrene.  Of  a  large  number  of 
persons  vaccinated  at  the  same  time  but  with  different  lymph,  none 
suffered  (London  Medical  and  Physical  Journal,  vol.  4,  p.  488). 

Mr.  Wakley  mentions  the  case  of  two  infants,  aged  respectively  two  and 
six  months,  vaccinated  with  good  lymph  (originally),  preserved  in  a  bot¬ 
tle  for  thirty  or  forty  hours,  and  which  at  that  time  had  undergone  decom¬ 
position.  In  both  infants  the  arm  became  greatly  inflamed ;  one  of  the 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


323 


children  died  with  sloughing  of  the  wound,  and  the  other  had  abscesses 
form  in  the  joints  and  elsewhere,  but  recovered.  (Lancet,  July  10,  1852.) 

Dr.  Tyinann  also  mentions  an  instance  where  fifty  persons  were  vacci¬ 
nated  with  a  fluid  produced  by  dissolving  otherwise  good  scabs  in  water, 
the  phial  having  been  carried  about  in  the  pocket  of  the  operator.  (American 
Medical  Times,  vol.  4,  p.  107.)  All  these  persons  had  very  severe  erysipe¬ 
latous  and  gangrenous  inflammation  supervene,  and  three  of  them  died. 
With  respect  to  the  danger  of  taking  lymph  from  persons  recently  blistered 
with  cantharides,  Mr.  Ceely  states  that  he  has  known  erythema  and  ery¬ 
sipelas  propagated  from  irritable ,  late  ruptured  or  exhausted  vesicles,  or 
from  apparently  healthy  ones  on  a  child  who  had  a  blister  behind  the  ear. 
(Papers,  etc.,  p.  125.) 

Dr.  Huder  relates  an  instance  of  five  children,  all  vaccinated  from  the 
same  child,  in  whom  very  quickly  the  arms  became  swollen  and  oedem- 
atous,  one  child  suffering  from  convulsions  and  two  from  abscesses,  no  vac¬ 
cine  vesicle  being  on  anj7  of  them.  The  child  from  whom  the  lymph  was 
taken  had,  the  evening  before,  a  blister  applied  behind  the  ear.  Four  of 
these  children  were  vaccinated  with  clean  lancets,  and  the  fifth,  being  at  a 
distance  from  the  others,  with  points.  (Medical  Gazette,  v.  13,  p.  440.) 

Husson  relates  also  the  case  of  two  persons  in  whom  sloughing  ulcers 
resulted  from  the  application  of  vaccine  lymph  to  a  surface  blistered  with 
cantharides.  (Dec.  des  Siences  Med.,  tome  56,  p.  423.) 

Doctors  Seaton  and  Buchanan  mention  three  public  vaccinators  who 
made  use  of  a  moist  lymph,  preserved  in  a  bottle,  after  it  had  been  kept  for 
a  week ;  and  one  vaccinator  expressed  his  opinion  that  the  lymph  being 
ammonical  and  putrid,  was  no  obstacle  to  its  success,  nor  to  the  regular 
course  of  the  vaccine  disease  that  was  produced  by  its  insertion.  (Sixth 
Beport  of  the  Medical  Officers  of  the  Privy  Council,  p.  102.  On  Vaccina¬ 
tion,  by  Edward  Ballard,  M.  D.,  pp.  84-89.) 

Doctor  Paul  F.  Eve  does  not  admit  the  possibility  of  the  inoculation  of 
erysipelas  by  vaccination,  as  will  be  seen  from  the  following  extract  from 
his  article  on  the  health  of  the  Southern  Army  : 

<l  Erysipelas  by  Vaccination.  In  regard  to  the  inoculation  of  erysipelas  by  vaccina¬ 
tion,  independant  of  a  peculiar  atmospheric  influence,  and  irrespective  of  some  adventi¬ 
tious  circumstances  connected  with  a  wound,  I  am  not  prepared  to  admit.  We  are  all 
familiar  with  the  idiopathic  variety  of  this  affection  attacking  the  cutaneous  and  mucous 
surfaces,  at  times,  too,  becoming  epidemic,  and  apparently  in  affinity  with  puerperal  per¬ 
itonitis,  and  we  know  the  traumatic  type ,  but  surely  this  disease  does  not  originate 
from  a  specific  virus.  It  is  evidently  infectious,  but  not,  I  believe,  contagious.  A  dis¬ 
tinguished  surgical  writer,  admitting  that  it  is  inocuable,  states  expressly  that  it  would 
be  impossible  for  it  ever  to  appear  in  a  sound  individual.  There,  then,  must  be  a  predis¬ 
position  in  the  general  system,  it  would  seem  in  every  instance,  usually  induced  by  ma¬ 
laria,  before  it  is  developed.  And  if  this  be  true,  namely,  that  the  attack  depends  for 
its  origin  upon  a  peculiar  state  and  condition  of  the  patient’s  health,  is  it  not  then  unwise, 
not  to  say  erroneous,  to  suppose  that  erysipelas  occurring  after  vaccination  is  due  to  a 
poison  escorted  by  vaccine  matter  into  the  system  ?  I  do  not,  therefore,  believe  it  inocu- 
lable  by  this  little  operation.” 

The  view7  maintained  by  Hippocrates  and  his  followers,  that  erysipelas 
was  a  disease  originating  from  some  intestine  commotion  of  the  humors,  and 
that  the  offending  matter  was  thrown  off  or  eliminated  by  means  of  the 
skin,  has  been  held  by  a  large  number  of  writers,  with  various  modifica¬ 
tions  and  slight  additions  up  to  the  present  time.  The  French  especially 
advocate  this  view,  and  as  a  general  rule  deny  the  contagiousness  of  ery¬ 
sipelas.  The  English  writers,  on  the  other  hand,  are  almost  unanimous  in 
considering  the  disease  as  capable  of  propagating  itself  by  contagion  under 
certain  circumstances.  Dr.  Cullen  admitted  a  species  of  erysipelas  capa¬ 
ble  of  throwing  off  contagious  emanations.  He  says,  "This  disease  is  not 


324 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


commonly  contagious,  but  as  it  may  arise  from  an  acrid  matter  externally 
applied,  so  it  is  possible  that  the  disease  may  sometimes  be  communicated 
from  one  person  to  another.” 

The  first  well-authenticated  facts  militating  against  the  old  notions,  and 
proving  the  contagious  nature  of  erysipelas,  were  published  by  Dr.  Wells 
in  1798  5  for  although  Sauvages,  in  his  aNosologia  Methodica,”  published 
thirty  years  before,  admits  an  erysipelas  contagiosum ,  his  views  are  obscure 
and  his  authority  doubtful,  as  the  epidemic  of  Toulouse  in  1715,  to  which  he 
refers  in  support  of  his  opinion,  appears  to  have  been  scaflatina,  and  not 
erysipelas.  The  examples  brought  together  by  Dr.  Wells,  in  which  this 
complaint  appeared  to  be  unequivocally  propagated  by  contagion,  have 
been  sustained  by  similar  cases,  described  by  Pitcairn,  Stevenson,  Gibson, 
Lawrence,  Gregory,  Elliotson,  Arnott,  Watson,  Rogers,  Goodfellew,  and 
other  English  physicians. 

The  question  of  the  possibility  of  communicating  the  poison  of  erysipelas 
along  with  the  virus  of  the  vaccine  disease,  is  intimately  associated  with 
that  of  the  contagiousness  of  erysipelas. 


FACTS  ILLUSTRATING  THE  PROPAGATION  ON  ERYSIPELAS 

BY  CONTAGION. 

In  the  brief  discussion  it  was  freely  admitted  that  erysipelas  at  times  prevails  as  an 
epidemic,  and  appears  to  he  produced  by  some  general  epidemic  influence,  and  that  in 
many  cases  the  disease  may  he  most  plausibly  accounted  for  by  sudden  changes  of  atmos¬ 
pheric  temperature,  along  with  considerable  moisture,  together  with  derangement  of  the 
bowels,  and  the  effects  of  particular  articles  of  food,  ardent  spirits  and  vicious  habits  ; 
and  that  isolated  cases  frequently  occur  in  private  families,  and  even  in  hospitals,  in 
which  the  disease,  as  is  often  the  case  with  typhus  fever,  typhoid  fever,  hospital  gan¬ 
grene,  pyaemia  and  Asiatic  cholera,  spreads  no  farther. 

The  rapid  propagation  of  erysipelas,  both  in  the  sick  room  and  in  the  wards  of  the  hos¬ 
pital,  has  been  so  frequently  observed  that  no  doubt  can  exist  of  this  disease  being  under 
certain  circumstances  communicated  by  emanations,  by  fomities,  or  by  some  palpable 
virus.  The  adoption  of  this  proposition  does  not  at  all  overthrow  the  belief  which  we 
also  hold,  that  the  origin  and  spread  of  erysipelas  in  hospitals,  and  in  private  families, 
will  depend  upon  the  livgenic  condition  of  the  wards  and  rooms,  and  upon  the  state  of 
the  constitution  of  the  patients. 

It  is  the  intention  of  this  brief  note  to  detail  facts,  rather  than  to  enter  into  any  hypo¬ 
thetical  discussion. 

In  the  summer  of  1760,  a  person  laboring  under  erysipelas  of  the  face  was  brought  into 
St.  Thomas  Hospital,  in  London,  where  he  died.  Another  patient,  having  a  different 
disease,  was  put  into  the  same  bed  before  it  was  duly  purified.  This  patient  was  shortly 
after  seized  with  erysipelas  of  the  face. 

Several  other  persons  in  the  hospital  were  then  attacked,  among  whom  was  an  upper 
nurse,  or  sister,  and  she  died.  A  rumor  hence  arose  that  the  plague  had  got  into  the  hos¬ 
pital;  and  so  widely  did  this  opinion  spread  that  an  advertisement  was  inserted  into  the 
newspapers  of  the  day,  contradicting  the  rumor.  Dr.  Bailie  described  it  as  spreading 
also  in  St.  George  Hospital,  London,  and  Dr.  Cullen  in  the  hospital  at  Edinburgh.  Dr. 
Wells  has  brought  together  several  examples  in  which  the  complaint  appeared  to  be  une¬ 
quivocally  propagated  by  contagion. 

“I  visited, says  Dr.  Wells,  on  the  eight  of  Augnst,  1796,  in  Vine  street,  Clerkenwell,  an  elderly  man- 
named  Skelton,  who  had  been  attacked  several  days  before  with  erysipelas  of  the  face.  In  about  a  week  af* 
terwards  he  died.  On  the  nineteenth  of  the  following  month,  I  saw  Mrs.  Dyke,  of  about  seventy  years  of 
age,  the  landlady  of  the  house  in  which  Skelton  had  been  a  lodger,  and  found  her  laboring  under  an  ‘erysipelas 
of  her  face.  I  inquired  whether  any  other  person  in  her  house  had  been  ill  of  the  same  disease  since  the 
death  of  Skelton,  and  was  told  that  his  wife  had  been  seized  with  it  a  few  days  after  his  decease,  and  had 
died  with  it  in  about  a  week.  During  my  attendance  upon  Mrs.  Dyke,  an  oid  woman,  her  nurse,  was  at¬ 
tacked  with  the  same  disorder,  and  was  sent  to  the  parish  workhouse,  whore  she  died.  Mrs.  Dyke  has 
since  informed  me  that  a  young  man,  the  nephew  of  Skelton,  was  taken  with  the  disease  of  which  his  uncle 
died,  shortly  after  visiting  him,  and  survived  the  attack  only  a  few  days.  That  she  herself  had  been  several 
times  with  Skelton,  and  his  wife  during  their  sickness,  and  after  death  had  removed  some  furniture  from 
the  room  they  occupied  to  her  own  apartment.” — Transactions  of  a  Society  for  the  Improvement  of  Medical 
and  Chirurgical  Knowledge. 

Dr.  Wells  relates  other  histories  of  the  same  kind,  which  in  like  manner  occurred  whet\ 
there  was  no  epidemic  of  erysipelas  prevailing. 


Spurious  Vaccination  :  Joseph  Jones,  M.  I). 


325 


Dr.  Pitcairn  attended,  in  February,  1797,  a  lady  with  child-bed  fever,  who  had  erysip¬ 
elatous  inflammation  in  her  skin.  Her  new-born  babe  had  erysipelas  of  the  pudendum, 
and  both  mother  and  child  died  after  a  few  days’  illness.  Eight  days  after  the  death  of 
the  child,  the  lady’s  mother  and  a  servant  maid,  both  of  whom  had  attended  the  child  in 
its  illness,  were  attacked  with  erysipelas  faciei,  irom  which  both  recovered. 

Dr.  Stevenson  details  briefly  the  results  of  twenty-one  caess  of  erysipelas  which  oc¬ 
curred  in  his  practice  in  1821-2 : 

‘‘It  sp'read,  in  many  instances,  through  the  members  of  the  same  family  ;  in  some  it  appeared  soon  after 
visiting  friends,  or  relatives,  during  the  period  of  the  disease.  A  person  who  was  attacked  while  in 
attendance  on  an  erysipelatous  patient,  went  home  to  her  parents,  who  resided  at  some  distance,  as  soon 
as  she  was  taken  ill;  they  were  soon  successively  seized,  and  the  mother  died  in  a  few  days.”  (Transac¬ 
tions  of  the  Medico  Chirurgical  Society  of  Edinburgh,  v.  2.) 

Dr.  Gibson  has  recorded  similar  cases  which  came  under  his  observation  in  1822. 
(Transactions  Medical  Chirurgical  Society  of  Edinburgh,  v.  3.) 

“A  young  man  with  erysipelas  of  the  face,  was  brought  to  his  father’s  house  at  the  distance  of  some 
miles.  He  ultimately  recovered .  His  master  had  died  a  few  days  before  of  a  febrile  disease.  The  father 
of  this  young  man  was  attacked  with  erysipelas  in  both  bads  and  arms,  which  spread  to  the  face.  He  died 
in  a  few  days.  The  infant  son  of  a  gentleman  was  seized  with  erysipelas  on  one  foot.  The  mother  was 
afterwards  with  erysipelas  of  the  scalp.  The  nurse,  who  suckled  the  child,  was  seized  with  symptoms  of 
pneumonia,  and  was  removed  to  her  father’s  house,  four  miles  off.  Her  father,  who  had  some  days  before 
her  arrival,  received  a  wound  of  the  scalp,  was  seized  with  erysipelas  of  the  face  and  scalp,  and  died 
soon  afterwards.  A  sister,  living  in  the  same  cottage,  had  fever  with  sore  throat,  from  which  she  slowly 
recovered .  Two  children  in  the  same  house  were  cut  off  with  what  appeared  to  be  the  croup.  The  disease 
in  the  sister  and  children  was  supposed  to  be  erysipelatous  inflammation  of  the  fauces  aud  trachea . 

A  woman  was  admitted  into  the  iufirmary  of  Montrose,  with  suppuration  of  the  hand,  which  had  followed 
an  attack  of  erysipelas.  Some  days  after  her  admission,  the  patients  in  the  two  beds  next  to  her  were  seized 
with  erysipelas.  It  was  afterwards  found  that,  notwithstanding  all  the  patients  were  removed  from  that 
ward,  and  the  process  of  cleaning,  whitewashing  and  fumigatingadopted,  the  disease  again  reappeared  when 
fresh  patients  were  placed  in  this  ward,  so  that  it  became  at  length  necessary  to  shut  up  the  infirmary  for  a 
time. — Cyclopmdla  of  Practical  Medicine,  Art.  Erysipelas. 

Mr.  Lawrence  also  mentions  similar  cases.  (Medico  Chirurgical  Transactions  of  Lou¬ 
don,  vol.  14.) 

Dr.  George  Gregory  in  his  valuable  lectures  on  the  Eruptive  Fevers,  has  expressed  his 
belief  in  the  contagious  nature  of  erysipelas  in  no  unequivocal  terms,  aud  his  views  are 
worthy  of  careful  consideration  in  this  connection. 

“A  connection  of  more  than  twenty  years  with  the  small-pox  hospital,  has  given  me  abundant  opportunities, 
not  only  of  confirming  the  truth  of  these  propositions,  but  of  showing  that  we  may  carry  our  views  much 
further.  I  feel  persuaded,  first  that  erysipelas  may  commence  in  an  hospital  without  the  suspicion  of  impor¬ 
tation.  2.  That  being  so  generated,  from  bed  to  bed,  it  may  spread  by  contagion.  3.  That  the  miasm  gen¬ 
erating  erysipelas  is  identical  with  that  which  in  lying  in  hospitals  generates  puerperal  peritonitis,  which 
in  foundling  hospitals  and  workhouse  nurseries  gives  rise  to  pudendal  gangrene  and  umbilical  ulceration — 
which  in  army  hospitals  generates  hospital  gangrene — which  in  hospitals  differently  circumstanced  is  found, 
to  occasion  a  malignant  form  of  cynanche,  both  mucus  and  cellular,  with  otitis,  glossitis,  an  asthenic  form  of 
laryngitis,  the  most  aggravated  type  of  typhus  gravior. 

“  The  origin  of  scurvy  in  crowded  and  ill-regulated  ships  is  obviously  a  branch  of  the  same  general  doc¬ 
trine.  A  destructive  miasm  is  there  generated  which  is  far  more  injurious  to  the  human  frame  than  the  use 
of  salt  provisions.  Whatever  be  the  exact  nature  (or  essence)  of  the  miasm  which  thus  generates  erysipe¬ 
las,  peritonitis,  gangrenous  ulceration  or  scorbutic  blotches,  it  is  something  depressing  to  the  vital  power. 

“  The  dependence  of  erysipelas  on  a  miasm  sui  generis  is  no  new  doctrine.  It  has  been  stated  over  and 
over  again  by  individual  writers,  but  it  has  never,  I  think,  been  urged  by  systematic  authors  with  the  im¬ 
portance  which  it  merits ;  nor  has  the  doctrine  been  received  as  one  of  the  avowed  axioms  of  pathology, 
f)r.'  Rollo,  in  a  treatise  entitled,  ‘A  Short  Account  of  a  Morbid  Poison  Acting  on  Sores,’  and  published  very 
early  in  this  century,  distinctly  announces  the  principle,  and  illustrates  the  intimate  connection  between 
erysi]Jfelas  and  hospital  gangrene. 

The  circumstances  which  lead  to  the  development  of  ochletic  miasm  have  never  been  investigated  with 
all  the  accuracy  which  is  desirable,  and  of  which  the  subject  is  certainly  susceptible .  The  first  in  im¬ 
portance  is  undoubtedly  overcrowding  the  wards  of  an  hospital.  When  the  French  academicians  (I  think 
it  was  early  in  the  French  Revolution)  were  laboriug  diligently  to  reform  the  abuses  in  the  Hotel  Dieu, 
some  of  them  were  at  the  pains  to  calculate  in  how  many  hours,  supposing  the  ward  to  have  been  her¬ 
metically  sealed,  all  the  patients  in  it  must  necessarily  have  died,  presuming  that  each  adult  requires  for 
his  support  a  gallon  of  air  per  minute.  The  time  was  wonderfully  short. 

2.  But  it  is  not  numbers  alone  which  are  to  be  con  sidered .  A  ward  might  safely  hold  fifty  cases  of  simple 
fracture,  which  would  not  with  safety  contain  twenty  cases  of  compound  fracture.  Something,  therefore, 
depends  on  the  nature  of  the  disorder.  All  disorders  which  throw  out  diseased. secretions  are  more  apt  to 
taint  and  vitiate  the  air  than  those  where  no  secreting  process  goes  forward.  It  is  on  this  account  that  the 
wards  of  the  Small-pox  Hospital  are  so  peculiarly  liable  to  generate  ochletic  miasm. 

3.  Another  element  of  great  importance  in  determining  the  sources  of  ochletic  miasm  is  the  degree  of 
attention  bestowed  on  cleanliness.  If  the  bed  linen,  mattresses,  imlliasses,  sheets,  and  blankers,  be  fre¬ 
quently  changed,  the  floors  well  cleaned,  and  the  walls  frequently  whitewashed ;  if  the  nurses  be  careful 
to  carry  away  all  foul  secretions,  and  to  purify  the  patient’s  body  by  an  abundance  of  soap  and  water ;  in 
short,  if  the  internal  regulations  of  the  hospital  be  good,  miasm  would,  I  suppose,  be  rarely  engendered, 
even  though  the  ward  be  crowded . 

4.  A  fourth  element  must  enter  into  the  calculation,  and  that  is  a  good  supply  of  fresh  air.  This  by 
some  is  considered  all  in  all ;  but  it  is  not  so,  and  all  the  ventilation  in  the  world,  conducted  on  the  most 
scientific  principles,  and  superintended  by  Dr.  Reid  himself,  would  fail  in  preventing  ochletic  miasm,  if 
feather  beds  or  bolsters,  soaked  in  unhealthy  discharges,  are  permitted  to  remain  in  the  ward. 

5.  Dr.  Rollo  has  advanced  a  step  further  in  the  analysis  of  ochletic  miasm,  and  maintains  that  the  dis¬ 
position  to  erysipelas  and  its  correlative  diseases  (puerperal  peritonitis,  and  hospital  gangrene)  depends 
partly  on  a  peculiar,  but  hitherto  undetected  condition  of  the  atmosphere.  He  is  led  to  this  opinion  by 
observing  that  erysipelas  sometimes  shows  itself  in  the  airiest,  least  crowded,  aud  best  regulated  hospitals. 
Without  stopping  to  inquire  how  much  is  due  this  circumstance,  we  are  fully  warranted  in  saying  that  the 


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state  of  the  atmosphere  must  not  be  lost  sight  of  in  such  an  investigation.  We  known  on  the  authority  of 
Dr.  Lind,  that  in  Batavia  and  other  localities  notorious  for  malaria,  hospital  gangrene  and  erysipelas,  and 
every  sort  of  associated  disorder,  prevail  with  intensity  at  certain  seasons. 

Assuming  it  as  proved,  that  erysipelas  is  liable,  from  one  or  more  of  the  five  causes  now  detailed  (viz: 
accumulation  of  persons,  character  of  the  discharges,  want  of  cleanliness,  want  of  ventilation,  constitution 
of  the  atmosphere),  to  spread  epidemically,  it  is  still  to  he  shown  that  this  disease  throws  off  contagious 
emanations,  which  can,  per  se,  independent  of  any  such  influences,  propagate  the  like  complaint. 

“Dr.  Wells  has  met  this  question  fairly  by  detailing  a  variety  of  cases  where  erysipelas  spread  by  con¬ 
tagion  in  private  houses,  and  under  circumsrances  calculated  to  exclude  all  agency  save  that  of  simple  con¬ 
tagion.” 

Dr.  Gregory  supports  bis  views  by  a  reference  to  the  cases  of  Dra.  Wells,  Pitcairn  and 
others,  and  also  by  his  own  individual  experience. 

Dr.  Elliotson,  in  his  “  Principles  and  Practice  of  Medicine,”  gives  the  following  ac¬ 
count  of  the  mode  in  which  he  contracted  the  disease  in  his  own  person  : 

“  I  recollect  once  having  had  it,  five  days  after  stooping  down  over  a  patient,  who  had  the  disease  in  so 
violent  a  form  that  he  died  of  it.  I  was  looking  into  the  state  ot  his  skin,  and  his  breath  came  into  my 
face.  I  turned  away  with  a  feeling  of  disgust,  and  said,  ‘  I  hope  I  have  not  caught  it.'  but,  five  days  after¬ 
wards,  having  forgotten  the  circumstance,  I  was  seized  with  erysipelas.  I  felt  chilly,  and  my  head  was 
sore;  and  I  bad  the  disease  violently.” 

Professor  Arnott  also  has  given  striking  examples  of  the  propagation  of  erysipelas 
from  one  person  to  another,  not  only  under  the  same  roof,  and  in  the  same  locality,  but 
also  when  the  parties  lived  at  a  distance  from  each  other,  and  the  intercourse  had  been 
but  for  short  periods  of  time. 

Dr.  Thomas  Watson,  who  advocated  the  view  that  erysipelas  is  contagious  gives  the 
following  incident  in  his  “Lectures  on  the  Principles  and  Practice  of  Physic,”  which  had 
been  told  him  upon  good  authority: 

“  A  man  living  somewhere  in  Westminster  fell  ill  of  idopathic  erysipelas.  In  that  state  for  some  reason 
or  other,  he  was  removed  thence  ;  and  his  brother,  who  was  a  servant  in  or  near  Portland  Place,  received 
him  clandestinely  into  his  master’s  house,  and  allowed  him  (for  two  nights  I  believe)  to  share  his  bed.  That 
brother  was  soon  attacked  with  erysipelas  ;  and  in  the  course  of  his  illness  was  visited  by  his  master.  The 
master  was  also  attacked  ;  and  it  is  worthy  of  remark,  that  in  both  master  and  servant,  the  disease  showed 
itself  just  seven  days  after  they  had  respectively  come  near  another  who  was  affected  with  it.” 

Dr.  Rogers  has  related  a  case,  which  closely  resembles  that  of  Dr.  Elliotson : 

“  A  medical  student,  went  into  the  country,  and  was  requested  by  his  brother,  a  medical  man,  to  visit  an 
erysipelas  patient.  While  leaning  over  her  ho  became  conscious  of  a  nauseous  odor,  which  almost  caused 
him  to  be  sick.  A  few  days  after,  he  was  suddenly  seized  with  shivering,  followed  by  fever;  erysipelas 
shortly  came  on  in  the  head  and  face,  and  he  died  after  a  week’s  illness.” 

In  the  following  instance,  communicated  to  Dr.  Campbell  De  Morgan,  Surgeon  of  the 
Middlesex  Hospital,  by  Dr.  Goodfellow,  it  is  evident  that  the  disease  spread  from  bed 
to  bed: 

“In  the  epidemic  of  typhus  that  prevailed  in  the  autumn  of  1838,  more  or  less  of  erysipelas  was  con* 
stantly  to  be  found  in  the  wards  ;  and,  as  a  general  rule,  it  spread  from  bed  to  bed.  On  one  occasion,  how" 
ever,  this  was  more  than  usually  striking.  It  occurred  in  the  large  fever  ward,  containing  thirteen  beds, 
and  well  ventilated.  Erysipelas  attacked  a  patient  on  that  side  on  which  were  seven  beds.  Sbe  was  in 
the  bed  next  but  one  to  the  end;  the  patient  lying  in  the  next  bed,  the  third  from  tbe  end,  was  next 
attacked,  and  then  the  patient  at  the  end.  The  disease  successively  attacked  all  the  patients  in  the  order 
in  which  the  heds  were  placed,  until  it  reached  the  lower  end  of  the  ward.  It  then  attacked  the  patient 
lying  at  the  same  end  of  the  ward,  but  on  the  opposite  side,  and  spread  from  bed  to  bed  until  it  reached  the 
last  on  this  side,  the  patient  lying  in  which  was  the  only  one  who  escaped.  A  System  of  Surgery  by  Vari¬ 
ous  Authors,  Edited  by  Holmes,  pp.  247-8. 

Dr.  Steele,  in  bis  Annual  Report  on  Guy’s  Hospital  for  1863,  writes,  that  for  some  years 
past  it  has  been  customary  to  place  patients  suffering  from  erysipelatous  wounds  in  these 
(the  medical)  wards,  in  order  to  diminish  as  much  as  possible  the  risk  of  extending  in¬ 
fection  in  surgical  wards,  as  well  as  to  promote  recovery  in  the  patients  themselves.  It 
happened,  however,  that  in  one  of  the  wards  of  the  new  .hospital  into  which  a  patient 
suffering  from  erysipelas  was  placed,  in  the  course  of  the  past  year  five  persons  suffering 
from  otlier  complaints  were  attacked  with  the  disease ;  and  although  none  of  the  casoe 
were  attended  with  fatal  consequences,  the  occurrence  is  sufficient  to  point  out  the 
danger  which  mush  be  occasionally  apprehended.” 

Erysipelas  has  appeared  extensively,  and  for  long  periods,  in  the  Birmingham,  Edin¬ 
burg,  Glasgow,  and  London  hospitals  and  it  has  been  frequently  necessary  to  empty  and 
whitewash  the  wards  and  thus  rid  them  of  the  disease. 

Many  of  the  surgeons  of  the  English  navy  believe  in  the  contagiousness  of  erysipelas  ; 
and  it  has  been  debated,  whether  scrubbing  the  decks,  or  dry  rubbing  them  is  the  best 
mode  of  cleasing  a  ship  and  preventing  the  spread  ot  the  disease. 

The  old  Dreadnought,  hospital  of  the  Thames  is  said  to  have  been  so  impregnated  with 
the  contagious  matter  of  erysipelas  that  she  had  ultimately  to  bo  taken  up,  and  a  new 
vessel  substituted. 

There  was  a  diversity  of  opinion  amongst  the  Confederate  surgeons  with 
regard  to  the  contagiousness  of  erysipelas.  This  diversity  of  opinion  was 
clearly  referable  in  some  cases  to  dogmas  embraced  during  education,  and 


Spurious  Vaccination  :  Joseph  Jones .  M.  D. 


327 


to  a  want  of  careful  and  extended  observation,  and  investigation  of  the 
origin,  and  mode  of  propagation,  of  the  diseases  incident  to  camp  life.  The 
reliability  and  value  of  the  testimony  of  men  upon  such  questions,  clearly 
depends,  not  merely  upon  the  extent  of  the  field  of  observation,  but  also 
upon  the  mode  in  which,  and  the  intelligence  with  which,  the  phenomena 
are  investigated. 

Many  cases  occurred  during  the  progress  of  the  war,  in  which  erysipelas 
was  clearly  referable  in  its  origin  and  spread  to  the  crowding  together  of 
large  numbers  of  sick  and  wounded,  in  ill  ventilated  hospitals. 

The  following  communication  from  Dr.  J.  C.  Nott,  of  Mobile,  Alabama, 
illustrates,  not  only  the  dependence  of  erysipelas  upon  crowding,  but  also 
shows  that  in  such  cases,  in  like  manner  with  hospital  gangrene,  the  disease 
is  best  eradicated  by  scattering  the  patients  and  giving  them  free  ventila¬ 
tion.  It  would  be  surely  unwise  and  unphilosophic  to  refer  the  origin 
of  erysipelas  in  such  cases  to  an  atmospherical  influence,  for  the  disease 
was  most  prevalent  and  most  fatal  in  the  most  crowded  hospitals,  and 
was  most  speedily  and  effectually  destroyed  by  breaking  up  those  sources 
of  contagion. 

No  light  whatever  is  thrown  upon  the  subject  by  declaring  the  disease 
infectious  and  not  contagious  in  crowded  hospitals.  We  can  only  refer  the 
propagation  of  infectious  diseases  to  the  exhalations  from  the  sick,  or  from 
the  excretions  of  their  bodies,  which  act  upon  the  extended  surface  of  the 
lungs  and  skin  of  those  immersed  in  the  infected  atmosphere;  and  we 
know  that  in  the  case  of  the  two  most  contagious  and  infectious  diseases — 
small-pox  and  measles — the  diseased  actions  may  be  propagated  in  both 
ways  by  the  inhalation  ot  the  exhalations  of  the  sick,  as  well  as  by  direct 
contact  with  the  morbific  matters. 

Mobile,  November  21,  1866. 

Professor  Joseph  Jones,  M.  JD.  : 

Dear  Sir — Your  letter  came  to  band  yesterday,  together  with  two  numbers  of  your 
journal.  I  am  sorry  that  I  have  no  notes  or  statistics  relating  to  hospital  gangrene. 

My  connection  with  the  army  was  in  the  command  of  General  Bragg,  commencing 
about  six  weeks  before  the  battle  of  Shiloh.  I  had,  it  is  true,  been  the  Medical  Director 
in  Mobile  for  some  time  previously,  but  we  had  no  wounds  to  deal  with.  Very  soon  after 
we  got  to  Corinth  all  sorts  of  camp  diseases  prevailed  among  the  troops — diarrhoea,  ty¬ 
phoid  fever,  etc.,  and  erysipelas.  The  colonel  of  a  regiment  came  to  me  and  begged  me 
to  visit  a  small  brick  church  in  the  vicinity  of  Corinth,  in  which  his  men  were  dying  at 
a  fearful  rate  with  erysipelas.  On  visiting  the  church,  I  found  some  seventy  or  eighty 
sick  or  wounded  men  crowded  together  in  a  small  church,  and  about  one-half  of  them 
with  erysipelas.  There  had  been  daily  skirmishing  going  on,  and  about  one-fourth  of 
the  men  had  been  wounded.  The  disease  attacked  those  wounded,  as  well  as  others,  in¬ 
discriminately-  Many  of  them  were  dying  with  erysipelas  of  face  and  scalp,  who  had  not 
been  wounded,  and  I  never  saw  a  more  revolting  scene  than  this  hospital  presented.  I 
ordered  it  to  be  evacuated  at  once,  and  the  patients  to  be  removed  to  tents,  at  some  dis¬ 
tance  off  in  the  open  field.  The  effect  was  immediate  and  salutary.  The  erysipelas 
ceased  to  attack  others,  and  the  health  of  the  command  improved  rapidly. 

At  the  same  time  above  alluded  to,  we  had  some  cases  of  hospital  gangrene  among  the 
wounded  in  different  hospitals,  up  to  the  time  of  the  battle  of  Shiloh.  Being  occupied 
very  busily  in  office  as  Director  of  the  Post,  I  had  no  time  for  visiting  hospitals,  and  the 
battle  of  Shiloh  comiug  off  soon,  and  there  being  very  little  hospital  accommodation, 
we  were  compelled  to  send  off  in  every  direction  10,000  wounded  and  as  many  sick.  So 
1  saw  very  little  of  what  occurred  among  our  wounded. 

I  afterwards  went  into  Kentucky;  was  at  the  battle  of  Perryville,  and  other  smaller 
battles  ;  but  here  we  had  to  leave  our  wounded  behind,  after  every  battle. 

So  really  my  experience  has  not  been  extensive  or  satisfactory  in  hospital  gangrene.  I 
have  seen  a  good  many  scattering  cases  during  the  war,  and  have  found  them  best  treated 
by  the  application  of  nitric  acid,  iron,  tonics,  stimulants  and  good  diet. 

On  the  whole,  then,  my  observations  and  information  are  too  indefinite  to  be  worth 
much,  and  I  write  more  to  state  the  simple  fact  that  we  did  have  cases  of  hospital  gan¬ 
grene  before  and  after  the  battle  of  Shiloh,  and  I  looked  upon  it  as  close  akin  to  ery¬ 
sipelas.  Very  respectfully,  yours,  etc,,  J.  C.  NOTT. 


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Spurious  Vaccination :  Joseph  Jones,  M.  D. 


It  will  be  seen  from  the  following  statistical  information  and  sanitary 
report  of  the  Moore  Hospital,  Manassas  Junction,  Virginia,  for  the  month 
of  January,  1862,  that  in  this  hospital,  which  received  the  worst  cases  of 
typhoid  fever  and  pneumonia,  and  was  liable  to  sudden  and  unavoidable 
crowding  of  the  sick,  erysipelas  attacked  almost  universally  the  patients 
operated  on,  only  two  escaping. 

“Moore  Hospital,”  Manassas  Junction,  Va„  February  7,  1862. 
Thos.  Williams,  Surgeon,  C.  S.  A.,  Medical  Director  Army  of  Potomac  : 

Sir — I  have  the  honor  to  forward  the  report  of  the  “  Sick  and  Wounded  ”  of  the  Moore 
Hospital,  for  the  month  of  January.  The  face  of  it  shows  only  235  patients  admitted, 
while  77  of  these  have  died — a  fearful  mortality,  I  confess — and  did  it  extend  to  all  dis¬ 
eases  would  soon  decimate  our  army.  But  when  it  is  recollected  that  the  235  men  kept 
here  were  picked  out  of  over  2900  that  have  passed  through  and  were  sent  further  hack, 
and  that  those  kept  are  the  sickest — in  fact  a  number  came  in  moribund,  others  dying 
from  six  to  twenty-four  hours  after  their  arrival — the  mortality  does  not  appear  so  appal¬ 
ling.  At  the  beginning  of  January  there  were  remaining  114  sick  and  convalescents  ;  of 
these  25  died  during  the  past  month,  making  the  mortality  102.  The  report  shows  37 
cases  of  febris  typhoides,  with  17  deaths,  which  is,  strictly  speaking,  not  true,  as  there 
have  been  but  four  or  five  cases  of  wmll-developed  typhoid  fever  in  the  wards,  and  those 
so  diagnosed  are,  in  the  majority  of  cases,  simple  continued  fever,  taking  on  a  typhoid 
form,  but  wanting  in  all  the  particulars  of  typhoid  fever  proper  ;  and,  I  feel  confident, 
was  there  an  opportunity  afforded  for  post-mortem  examinations,  they  would  be  found 
wanting  in  the  pathological  changes  peculiar  to  the  disease. 

There  were  128  cases  of  pneumonia  treated,  with  a  loss  of  45,  almost  36  per  cent, 
though  not  large  when  the  condition  of  the  patients  at  the  time  of  entering  the  hospital 
is  taken  into  consideration  ;  a  large  majority  of  the  cases  are  sick  from  three  to  ten  days 
in  camp  before  they  are  brought  to  the  hospital.  Such  cases  presenting  bad  symptoms, 
but  still  not  necessarily  of  a  fatal  character,  after  a  ride  in  an  ambulance  or  wagon  of 
three  or  five  miles  over  a  rough  road,  are  placed  beyond  redemption.  Stinnflants  and 
carb.  ammonia  may  revive  the  vital  spark,  and  the  man  live  for  several  days,  and  occa¬ 
sionally,  I  am  happy  to  say,  has  elasticity  enough  about  his  constitution  to  get  well. 
As  an  evidence  of  the  fatality  caused  by  surrounding  disadvantages,  I  have  simply  to 
refer  to  some  ten  or  twelve  cases  of  pneumonia  in  my  nurses  where  every  case  has  re¬ 
covered,  each  one  of  them  showing  the  good  effects  of  antimony  in  the  early  stage  of  the 
disease.  , 

Those  sent  from  this  place  to  general  hospital,  have  been  convalescents  sent  further 
back  to  make  room  for  the  sick.  They  have  been  South  Carolinians  and  Mississippians, 
and  were  sent  to  Charlottsville  and  Warrenton. 

The  number  of  furloughs  (47)  is  large  for  the  number  of  patients  ;  but  when  it  is  con¬ 
sidered  that  all  of  the  wounded — at  least  60 — from  the  battle  of  Drainesville,  were  here, 
that  will  be  accounted  for. 

I  may  add,  that  the  two  cases  of  erysipelas  were  purely  idiopathic,  and  in  the  ward 
where  all  the  worst  wounded  were,  there  was  quite  a  number  of  other  cases  there,  arising 
from  any  little  operations  performed,  such  as  removing  a  bullet  or  spicula  of  bone,  but  two 
patients  operated  on  escaping.  On  one  of  those  1  ligated  the  carotid  artery  ;  in  the 
other,  amputation  of  the  thigh  was  performed.  The  latter  operation  was  performed 
three  weeks  since,  and  the  same  day  a  bullet  was  extracted  from  the  shoulder,  which 
immediately  took  on  erysipelatous  inflammation,  whilst  there  has  never  been  the  slighest 
symptoms  of  it  about  the  amputation.  In  several  of  these  cases,  and  especially  the  idi¬ 
opathic,  the  inflammation  was  not  confined  to  the  skin,  but  extended  to  the  subcutane¬ 
ous  areolar  tissue,  forming  what  Dr.  Stone,  of  New  Orleans,  says  is  different  from  ery¬ 
sipelas,  and  what  he  calls  “  subcutaneous  areolar  inflammation,”  never  running  its  course 
without  suppuration,  and  occasionally  to  an  enormous  extent,  invariably  presenting 
typhoid  (low)  symptoms.  I  am,  sir,  your  obedient  servant, 

J.  F.  BELL,  P.  A.  C.  S.,  Surgeon  in  Charge. 

These  examples  might  be  multiplied,  but  these  are  believed  to  be  suffi¬ 
cient  to  illustrate  the  experience  of  many  Confederate  surgeons  upon  the 
intimate  relations  of  erysipelas,  in  its  origin  and  spread  to  such  diseases  as 
hospital  gangrene,  which  were  known  to  be  contagious. 

On  the  other  hand  the  armies  were  never  so  healthy,  and  the  wounded 
were  never  so  free  from  erysipelas  as  during  the  most  active  campaigns. 

The  army  of  Gen.  T.  J.  Jackson  (Stonewall)  during  its  active  campaign 
in  the  Valley  of  Virginia  was  remarkably  healthy,  and  the  wounded,  as  I 


Spurious  Vaccination :  Joseph  Jones,  M.  D. 


329 


ascertained  by  a  personal  inspection  and  examination  of  the  records  of  sev¬ 
eral  of  the  largest  hospitals  connected  with  the  department  commanded 
by  this  distinguished  soldier,  were  exempt  to  a  great  degree  from  both 
erysipelas  and  hospital  gangrene.  This  immunity  was  due  to  several 
causes,  but  chiefly  to  the  active  habits  and  good  morale  of  his  soldiers,  to 
the  comparatively  abundant  supplies  of  this  rich  country,  and  to  the  large 
and  commodious  hospitals  established  at  Staunton  and  other  eligible 
points  in  this  elevated  and  healthy  region.  The  truth  of  this  assertion 
will  be  sustained  in  the  following  sanitary  report  of  his  Medical  Director, 
Surgeon  Hunter  McGuire : 

New  Market,  Virginia,  April  15,  1862. 

S.  P.  Moore,  Surgeon  General,  C.  S.  A.: 

Sir — I  Lave  the  honor  to  forward  tlie  consolidated  report  of  sick  and  wounded,  and  the 
return  of  the  medical  officers  serving  in  the  Army  of  the  Valley  of  Virginia  for  the  month 
of  March,  1862,  (Major  General  Jackson’s  Command). 

Though  subjected  to  long  and  sometimes  forced  marches,  the  health  of  this  army  was 
better  during  the  month  of  March  than  during  any  other  since  its  organization.  It  is  a 
fact  well  known  to  regimental  surgeons  and  commanders,  that  the  numbers  reported 
sick  during  marches,  even  when  they  are  long  and  fatiguing,  provided  the  weather  is 
clear  and  dry,  is  less  than  that  which  occurs  wheu  troops  are  stationary  and  subjected 
to  the  ordinary  duties  of  camp. 

Towards  the  end  of  tlie  month  recruits  and  drafted  men  were  added  to  the  regiments, 
and  the  amount  of  sickness  increased;  indeed,  the  large  proportion  of  those  reported 
sick  belong  to  the  men  recently  attached  to  the  regiments,  who  are  not  yet  inured  to  the 
hardships  of  a  soldier’s  life,  I  enclose  also  a  list  of  the  killed  and  wounded  of  this  army, 
in  the  engagement  near  Winchester,  March  23,  1863.  It  numbers  sixty-one  killed  and 
three  hundred  and  sixty-one  wounded.  Some  of  the  latter  were  mortally  wounded,  and 
have  since  died,  which  increases  the  number  of  dead,  as  far  as  known,  to  eighty-eight, 
and  proportionately  reduces  the  number  of  wounded.  One  hundred  and  fifty-seven  of 
the  wounded  were  removed  from  the  field,  the  rest  fell  into  the  hands  of  the  enemy.  It 
is  gratifying  to  know  that  our  dead  were  decently  buried  by  the  citizens  of  Winchester, 
and  that  our  wounded  have  received  every  attention  from  the  physicians  and  ladies  of 
that  place.  Very  respectfully,  your  obedient  servant, 

HUNTER  McGUIRE,  Medical  Director  Army  Valley  of  Virginia. 

While  we  do  not  at  all  deny,  that  erysipelas  at  times  prevails  as  an  epi 
demic,  and  appears  to  be  produced  by  some  general  epidemic  influence, 
and  that  in  many  cases  the  disease  may  be  most  plausibly  accounted  for, 
by  sudden  changes  of  atmospheric  temperature,  along  with  considerable 
moisture,  together  with  derangement  of  the  bowels,  and  the  effects  of  par¬ 
ticular  articles  of  food  ;  at  the  same  time  there  are  facts  to  show  that  this 
disease  is  at  times,  if  not  always,  contagious. 

Neither  would  we  be  understood  as  insinuating,  that  instances  of  its 
transmission  by  contagion,  are  common  in  private  practice,  for  isolated 
cases  frequently  occur  in  private  families  in  which  no  member  of  the  family 
and  no  nurse  contracts  the  disease. 

The  origin  and  spread  of  erysipelas  in  hospitals,  will  depend  upon  the 
hygienic  condition  of  the  wards,  and  upon  the  state  of  the  constitution  of 
the  patients. 

Many  of  the  Confederate  surgeons  appeared  to  be  aware  of  the  dangers 
attending  the  indiscriminate  use  of  sponges,  dressings,  and  uncleansed 
wash  bowls,  when  erysipelas  was  present  in  their  wards.  When  wounds 
were  cleansed  with  sponges  or  rags  which  had  been  used  on  erysipelatous, 
patients,  it  was  frequently  observed  that  the  disease  appeared  ;  and  such 
propagation  appeared  to  be  clearly  referable  to  the  transference  of  the  con¬ 
tagious  matter. 

It  can  be  shown  therefore  that  the  evidence  of  contagion  in  erysipelas 
rests  upon  nearly  the  same  grounds  as  in  the  well  known  contagious 
diseases,  scarlet  fever,  measles,  and  typhus  fever. 


330  Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


Many  of  the  British  physicians  and  surgeons  entertain  hut  little  doubt 
of  the  connection,  if  not  the  identity  of  erysipelas  with  puerperal  fever. 
Without  entering  into  an  extended  examination  of  the  facts  upon  which 
this  view  rests,  it  will  be  sufficient  to  recall  the  well  known  fact,  that  in¬ 
oculation  with  the  fluid  of  a  female  who  had  died  of  puerperal  fever,  is  a 
most  fatal  source  of  diffuse  cellular  inflammation  to  the  dissector. 

Dr.  George  Gregory,  in  his  Lectures  on  the  Eruptive  Fevers,  says  that 
he  had  heard  of  a  case  where  vaccine  matter  taken  from  the  arm  of  a  child 
laboring  under  erysipelas,  had  communicated  both  diseases. 

And  Anally,  Dr.  Willan  has  testified  that  if  a  person  be  inoculated  with 
the  fluid  contained  in  the  phlyctinae  or  vesicles  of  a  genuine  erysipelas,  a 
red,  painful,  diffused  swelling  and  inflammation  analogous  to  erysipelas  is 
produced. 

This  experiment  has  not,  as  far  as  we  are  aware,  been  repeated  $  and, 
with  such  a  direct  demonstration  of  the  possibility  of  communicating  ery¬ 
sipelas  by  inoculation,  we  are  at  a  loss  to  know  upon  what  principles  of 
reasoning,  authors,  who  have  never  performed  a  single  experiment  them¬ 
selves,  assume  the  right  of  setting  aside  the  assertion  of  Dr.  Willan. 

By  these  facts,  therefore,  as  well  as  by  those  which  occurred  during  the 
recent  war  amongst  the  soldiers  and  citizens  of  the  Confederate  States,  we 
are  justified  in  drawing  the  conclusion  that  it  is  possible  to  communicate 
the  poison  of  erysipelas  through  the  medium  of  the  vaccine  matter 

The  practical  conclusion  which  we  draw  from  this  discussion,  is  that  : 

As  far  as  possible  soldiers,  especially  during  long  and  fatiguing  campaigns, 
and  when  crowded  in  hospitals  and  barracks,  should  be  vaccinated  with  the 
lymph  or  vaccine  virus  from  young  healthy  children.  It  is  best,  both  in  civil 
and  in  military  practice,  not  to  use  the  vaccine  virus  from  the  arms  of  soldiers, 
because  their  mode  of  life  is  an  artificial  one,  to  a  great  extent ;  a  stereo¬ 
typed  life  of  restraint  and  hardship,  and  of  great  sameness  of  diet,  and 
consequently  a  life  liable  to  great  excesses  and  irregularities  of  habits,  and 
to  great  and  sudden  variations  of  health,  as  well  as  to  slow  and  impercep¬ 
tible  deterioration  of  nutritive  fluids. 

The  quality  of  the  vaccine  virus  will  depend,  in  great  measure,  upon  the 
manner  in  which  the  nutrition  of  the  body  is  performed.  We  use  the  word 
nutrition  in  its  largest  sense.  Yaccine  matter  obtained  from  the  arms  of 
the  feeble  and  often  scorbutic  convalescents  of  crowded  civil  and  military 
hospitals,  is  wholly  unfit  for  the  propagation  of  the  vaccine  disease.  Of 
all  places,  civil  and  military  hospitals  are  the  very  last,  to  which  the  pro¬ 
fession  should  look  for  supplies  of  vaccine  matter ;  and  yet,  during  the  re¬ 
cent  war,  it  was  in  the  crowded  hospitals  that  vaccination  was  most  dilli- 
gently,  perpetually  and  indiscriminately  performed.  In  these  most  destruc¬ 
tive  centres  of  contagious  diseases  of  typhoid-fever,  erysipelas,  hospital 
gangrene,  and  pyaemia,  the  so-called  vacciue  matter  passed  from  soldier  to 
soldier  in  an  endless  round.  Is  there  any  marvel  that  under  such  a  system , 
enforced  by  military  law,  the  matter  should  have  progressively  deteriorated, 
and  the  accidents  of  vaccination  (spurious  vaccination)  have  become  both 
common  and  serious  ? 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


331 


SECTION  VII.— FRESH  AND  DRIED  VACCINE  LYMPH  AND 
SCABS  FROM  PATIENTS  SUFFERING  WITH  SECONDARY 
OR  CONSTITUTIONAL  SYPHILIS  AT  THE  TIME  AND  DUR¬ 
ING  THE  PROGRESS  OF  VACCINATION  AND  THE  VACCINE 
DISEASE  —  PROFESSOR  EVE,  DOCTORS  KRATZ,  FUQUA, 
RAMSEY,  CRAWFORD,  PERCIVAL,  STOUT,  WOODWARD, 
HUBBARD,  BOLTON  AND  OTHERS  ON  THE  RELATIONS  OF 
SYPHILIS  TO  SPURIOUS  VACCINATION— DISCUSSION  OF 
THE  RELATIONS  OF  SECONDARY  OR  CONSTITUTIONAL 
SYPHILIS  TO  VACCINATION— THE  POSSIBILITY  OF  COM¬ 
MUNICATING  TUBERCULOSIS  AND  CANCER  BY  INOCULA¬ 
TION— THE  POSSIBILITY  OF  COMMUNICATING  SECONDARY 
OR  CONSTITUTIONAL  SYPHILIS  BY  INOCULATION— TES¬ 
TIMONY  OF  TORELLO,  1498;  WILLIAM  CLOWES,  1637;  GID¬ 
EON  HARVEY,  1665 ;  DANIEL  TURNER,  1717 ;  JOHN  HUNTER, 
1776;  AND  OF  DOCTORS  DUNCAN,  WATSON,  HAMERTON, 
EGAN,  PRICE,  RIZZI,  WALLER  AND  OTHERS,  ON  THE  CON¬ 
TAGIOUSNESS  OF  SECONDARY  SYPHILIS. 


.  THE  POSSIBILITY  OF  COMMUNICATING  CONSTITUTIONAL  SYPHILIS  THROUGH 
THE  MEDIUM  OF  VACCINE  VIRUS— TESTIMONY  OF  M.  VIENNOIS,  DRS.  PAC- 
CHIOTTI,  MARONE,  POGUE,  DEPAUL  AND  OTHERS— SMALL-POX  EPIDEMIC 
IN  MOBILE  DURING  WINTER  OF  1865-6— SYPHILITIC  VACCINE  AND  THE 
MEANS  OF  PREVENTING  IT — IN OCU& ABILITY  OF  TUBERCLE— MORTALITY 
OCCASIONED  IN  NEW  ORLEANS  AND  THE  MISSISSIPPI  VALLEY— POSSIBIL¬ 
ITY  OF  TRANSMITTING  SCROFULA  BY  VACCINATION— 1NOCULABILITY  OF 
CANCER— CONTAGIOUS  NATURE  OF  CONSTITUTIONAL  SYPHILIS— COM¬ 
MUNICATION  OF  SYPHILIS  BY  VACCINATION— MODIFIED  OR  LACTO-VARIO- 
LOUS  INOCULATION— VARIOLATION  OF  THE  COW— ANIMAL  VACCINATION. 

We  examined  at  different  times,  during  the  progress  of  the  recent  war, 
and  also  had  under  treatment,  various  skin  affections,  which  presented  the 
characters  of  the  cutaneous  diseases,  characteristic  of  secondary  syphilis, 
which  were  directly  traceable  to  impure  vaccine  virus.  I  saw  several  cases 
in  which  enlarged  buboes  in  the  axilla  and  groin  accompanied  the  peculiar 
skin  affection  induced  by  impure  vaccine  matter.  Yo  such  results  followed 
vaccination  as  performed  by  myself  or  immediately  under  my  direction  du¬ 
ring  the  war ;  these  accidents  were  avoided  in  my  civil  and  military  prac¬ 
tice,  by  adhering  rigidly  to  the  rule  of  using  lymph  from  the  arms  of  healthy 
children  and  infants ;  the  opportunity  therefore  did  not  present  itself  of  ob¬ 
serving  and  carefully  noting  the  disease  in  its  first  stages.  The  cases  re¬ 
sembling  constitutional  syphilis  and  which  were  said  to  have  resulted  di¬ 
rectly  from  vaccination,  which  came  under  my  observation  and  treatment, 
were  as  a  general  rule  of  long  standing,  and  had  been  collected  from  differ¬ 
ent  hospitals,  and  from  various  regiments,  serving  in  widely  separated 
districts.  ‘ 


332 


Spurious  Vaccination:  Joseph  Jones,  M.  T>. 


In  the  summer  of  1863,  I  examined  a  large  number,  and  if  my  memory 
is  correct,  over  two  hundred  eases  of  severe  skin  affections  and  general 
constitutional  derangement  resulting  from  vaccination,  in  the  large  hospi¬ 
tals  in  and  around  Richmond,  Virginia.  In  these  cases,  as  well  as  in  those 
examined  in  other  parts  of  Virginia,  South  Carolina,  and  Georgia,  great 
difficulty  was  experienced  in  tracing  the  impure  matter  to  a  definite  source, 
that  is  to  the  point  at  which  it  became  contaminated  orxdeteri orated.  I  do 
not  wish  to  be  understood  as  asserting  or  insinuating  that  this  large  num¬ 
ber  of  cases  presented  the  symptoms  of  secondary  syphilis ;  so  far  from 
this  it  appeared  to  me  that  those  cases  which  presented  the  most  complete 
resemblance  with  constitutional  syphilis  were  not  as  numerous  as  those 
which  were  clearly  referable  to  scorbutic  and  other  deranged  conditions  of 
the  system  induced  by  fatigue,  exposure  and  bad  diet. 

During  the  progress  of  the  war,  the  subject  of  the  relation  of  vaccina¬ 
tion  to  constitutional  syphilis,  engaged  my  most  anxious  thought  and  I 
had  determined  to  make  it  a  special  snbjcct  of  investigation  in  the  field 
and  general  hospitals,  immediately  upon  the  completion  of  my  investiga¬ 
tions  upon  typhoid  fever,  malarial  fever,  small-pox,  hospital  gangrene, 
and  pyaemia,  believing  that  a  correct  solution  of  this  difficult  and  important 
question  was  to  be  obtained  only  by  a  personal  examination  of  the  cases  as 
they  arose  in  the  regiments  serving  in  the  field,  and  a  careful  collection  and 
examination  of  the  testimony  of  the  regimental  surgeons  and  assistant 
surgeons.  From  experience  gained  in  other  investigations  in  the  field  and 
general  hospitals,  1  was  well  aware  that  such  labors  required  much  time 
and  were  beset  with  many  difficulties.  From  the  terrible  drain  upon  the 
Confederate  States  for  men,  the  hospitals  and  convalescent  camps  were 
subjected  to  the  most  rigid  scrutiny,  and  all  men  not  absolutely  disabled  * 
from  every  kind  of  duty,  were  at  the  earliest  possible  moment  transferred 
to  clerical  and  light  duty  in  the  quartermaster,  commissary,  medical  and 
purveying  departments. 

From  the  great  disparity  of  numbers,  and  from  the  immense  extent  of 
country  in  which  the  operations  wfere  conducted,  the  Confederate  troops 
were  in  perpetual  motion.  The  same  soldiers,  in  the  course  of  a  few  months, 
conducted  fatiguing  campaigns  which  extended  over  entire  States,  and 
fought  bloody  and  desperate  battles  with  superior  forces  in  localities  separ¬ 
ated  by  hundreds  of  miles.  Whole  armies  that  had  been  victoriofis  at  some 
remote  portion  of  the  border,  or  of  the  Atlantic  and  Gulf  coasts,  were  sud¬ 
denly  transported  by  railroad,  across  the  entire  Confederacy,  to  take  their 
immediate  part,  without  rest,  in  the  bloody  battles  of  the  mountains  of 
Tennessee  and  in  the  valleys  of  Virginia.  These  difficulties  were  experi¬ 
enced  to  a  greater  or  less  degree  by  every  medical  officer  who  undertook 
the  investigation  of  this  subject ;  and  it  has  been  rendered  still  more  obscure 
by  the  sudden  manner  in  which  the  struggle  terminated,  and  by  the  loss  of 
the  most  extensive  and  valuable  reports  on  file  in  the  Surgeon  General’s 
office  at  Richmond. 

I  have  sought  to  remedy,  in  a  small  degree,  these  defects,  by  addressing 
inquiries  to  a  large  number  of  those  who  formerly  occupied  positions  in  the 
medical  service  favorable  for  the  investigation  of  the  causes  of  the  acci¬ 
dents  following  vaccination.  It  must  be  confessed  that,  up  to  the  present 
time,  the  replies  received  to  these  inquiries  have  been  wanting  in  that  full 
and  accurate  detail  of  individual  cases,  which  is  so  necessary  to  the  proper 
solution  of  the  question,  whether  the  lymph  or  scab  of  a  vaccine  vesicle 
its  peculiar  virus,  contain  another  infections  principle,  as  that  of  syphilis. 

The  affirmative  of  this  question  was  held  by  many,  both  in  civil  and 
military  practice ;  and  a  number  of  the  Confederate  surgeons  boldly  took 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


333 


the  ground  that  secondary  syphilis  could  be  communicated  along  with  the 
vaccine  virus,  and  especially  when  the  dried  scabs  were  employed.  In  the 
records  upon  this  subject,  which  we  examined  in  the  Surgeon  General’s 
office  in  the  Confederate  Capital,  this  view  was  clearly  announced.  Several 
of  these  reports  had  been  prepared  in  accordance  with  a  direct  order  issued 
by  the  Surgeon  General,  directing  a  careful  investigation  into  the  origin  and 
causes  of  spurious  vaccination.  The  history  and  results  of  a  portion  of 
the  investigations  ordered  by1  Dr.  Moore  are  given  in  the  following  extracts 
from  an  official  letter  : 

Professor  Joseph  Jones,  M.  D. : 

During  the  month  of  March,  1863,  Medical  Director  Guild  -was  so  impressed  with  the  importance  of 
this  affection  that  he  ordered  a  committee  of  investigation  into  the  extent  of  its  prevalence,  its  causes 
and  nature.  The  committee  limited  their  inspection  to  those  regiments  only  whose  medical  officers  had  re¬ 
ported  the  presence  of  this  “spurious  vaccination.”  The  committee  consisted  of  Surgeons  R.  G.  Breck¬ 
inridge,  now  of  Houston,  Texas;  Herndon,  of  Fredericksburg,  Virginia,  and - ,  of  North  Carolina. 

The  cases  of  spurious  vaccination  was  most  numerous  in  the  Twelfth  and  Sixteenth  Georgia  Regiments. 
In  one  of  those  regiments  we  found  over  one  hundred  cases  of  ulcerated  arms  and  hands,  and  in  many 
instances  extending  to  the  body  and  lower  extremities.  In  one  of  these  regiments  the  historical  connection 
with  syphilis  was  most  conclusive.  They  had  all  been  vaccinated  from  the  arm  of  a  comrade  of  very  disso¬ 
lute  habits,  who  had  just  returned  from  a  leave  of  absence.  This  soldier  was  at  this  time  in  camp,  and 
presented  unmistakable  evidences  of  syphilis.  I  do  not  think  I  err  when  I  state  that  there  was  no  chancre 
on  the  penis,  but  we  rested  our  opinion  of  the  existence  of  syphilis  upon  the  characteristic  sore  throat  and 
eruption,  and  his  confessions  as  to  the  recent  existence  of  chancre.  He  had  just  returned  irora  some  little 
village  in  Georgia,  and  informed  us  that  a  physician  practicing  there  had  taken  matter  from  his  arm  and 
inserted  it  into  the  arms  of  a  large  number  of  young  persons  in  his  neighborhood.  The  “vaccination”  in 
all  these  cases  was  done  by  the  soldiers  themselves,  and  not  by  their  medical  officers;  consequently,  acting 
upon  the  popular  idea  that  the  larger  the  sore  the  more  complete  is  the  pretection,  they  selected  the  worst 
sores  for  the  propagation  of  the  virus.  The  committee  agreed,  with  regard  to  the  worst  of  these  ulcers, 
that  their  appearance  and  progress  were  so  analogous  to  syphilides  that  they  did  not  hesitate  to  class  them 
as  such.  The  usual  treatment  for  syphilis  did  not  cure  nr  benefit  these  cases  with  any  marked  uniformity. 
We  find  a  ready  explanation  of  this  observation  in  the  condition  of  constitution  and  circumstances  under 
which  the  treatment  was  instituted — poor  diet,  scurvy,  and  camp  life.  *  *  * 

The  testimony  of  Dr.  J.  F.  Gilmore  is  decided  as  to  the  syphilitic  origin 
of  a  portion  at  least  of  the  cases  of  spurious  vaccination  in  the  Confederate 
Army  of  Northern  Virginia,  as  will  be  seen  from  the  following  comnmni 
cation,  kindly  placed  in  my  hands  by  the  late  Professor  Paul  F.  Eve,  M.  D. : 

[Copy,]  Mobile,  Ala  ,  Maj  27,  1867. 

Prof..  Paul  F.  Eve,  Nashville,  Tenn.  : 

Dear  Doctor — I  promised.  Dr.  Nott,  before  lie  left  ns  for  Baltimore,  to  write  Professor 
Jones,  relative  to  spurious  vaccination,  of  which  I  saw  a  great  deal  in  the  army  in  Vir¬ 
ginia,  and  as  I  am  in  your  debt  a  letter,  I  trust  you  will  pardon  me  for  doing  so  through 
yourself. 

The  small-pox  broke  out  in  the  army  in  Virginia,  shortly  after  the  battle  of  Sharps- 
burg,  whilst  we  were  in  camp,  in  the  valley,  in  the  vicinity  of  Winchester,  reorganizing 
and  watching  the  movements  of  McLellan.  The  first  case  occurred  in  the  brigade  of  Gen. 
G.  T.  Anderson,  of  Georgia. 

At  that  time,  I  was  the  Chief  Surgeon  of  McLaw’s  Division.  The  disease  did  not 
show  itself  in  my  command  until  the  latter  days  of  October.  The  first  case  occurred  in 
a  private  of  the  Thirteenth  Mississippi  Kegiment,  who  contracted  it  while  hauling  sup¬ 
plies  from  Staunton  for  the  army.  It,  however,  did  not  make  much  headway  until  after 
the  battle  of  Fredericksburg,  the  thirteenth  and  fourteenth  of  December,  I  believe. 

The  act  of  Congress  reorganizing  the  army  after  the  expiration  of  the  twelve  months’ 
volunteers,  provided  that  each  man  who  re-enlisted,  should  receive,  in  addition  to  the 
bounty,  a  furlough  for  thirty  days,  and  Gen.  Lee,  in  order  to  carry  out  the  provisions  of 
this  act,  without  materially  weakening  the  army,  issued  a  general  order  granting  fur¬ 
loughs  to  two  (2)  men  to  every  hundred  on  duty.  This  order,  I  think,  was  issued  whilst 
we  were  in  the  valley.  Shortly  after  the  battle  of  Fredericksburg,  a  private  in  Seinmes’ 
Georgia  Brigade  returned  to  his  command,  who  had  received  a  furlough  under  the  order. 
He  came  back  to  his  regiment,  with  what  he  supposed  was  an  ample  supply  of  virus  for 
all  of  his  friends,  a  large  number  of  whom  he  vaccinated,  not  only  in  his  own  brigade, 
but  also  in  Cobb’s.  In  this  way  the  impure  virus  obtained  a  stronghold  in  these  two 
brigades. 

McLaw’s  Division  was  composed  of  four  brigades:  Kershaw’s,  South  Carolina;  Barks¬ 
dale’s,  Mississippi  ;  Semmes’  and  Cobb’s,  Georgia  brigades.  I  don’t  recollect  that  I  saw 
a  single  case  in  either  Kershaw’s  or  Barksdale’s  commands,  but  in  the  other  two  com¬ 
mands  we  had  about  three  hundred  cases. 

By  the  direction  of  Surgeon  and  Medical  Director  L.  Guild,  I  had  two  hospitals  estab¬ 
lished,  one  for  Semmes’  and  the  other  Cobb’s  brigades  ;  Semmes’  under  the  charge  of  Sur- 


334 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


geon  Todd,  and  Cobb’s  under  the  charge  of  Surgeon  Eldridge.  For  some  cause  which  I 
don’t  recollect,  Dr.  Guild  thought  it  better  that  these  cases  should  not  be  sent  to  general 
hospital ;  and  it  being  impossible  to  obtain  suitable  buildings,  tents  were  used. 

The  cases  presented  the  appearances  that  are  familiar  to  those  of  us  who  were  con¬ 
nected  with  the  Confederate  army — large  rupia-looking  sores,  sometimes  only  one,  gen¬ 
erally  several  on  the  arm  in  which  the  virus  was  inserted.  In  a  number  of  cases,  these 
sores  extended,  or  rather  appeared,  on  the  forearm  ;  and  in  two  cases  that  I  saw,  they 
appeared  on  the  lower  extremities.  These  men  suffered  severely  from  nocturnal  rheuma¬ 
tism.  Several  cases  had,  to  all  appearances,  syphilitic  roseola. 

1  saw  enough  of  the  trouble  to  convince  me  thoroughly  that  the  virus  owed  its  impu¬ 
rity  to  a  syphilitic  contamination 

The  cases  all  improved  under  the  administration  of  the  iodide  of  potassium  and  vegeta¬ 
ble  diet.  In  some  of  the  cases,  Grau’s  combination  of  the  iodide  of  potassium  and  corro¬ 
sive  sublimate  was  employed. 

In  many  of  them  there  was  a  marked  scorbutic  tendency,  which  may  in  part  account 
for  the  bad  effects  of  the  virus ;  but  there  were  in  the  great  majority  of  the  cases  unmis¬ 
takable  evidences  of  syphilis. 

When  the  hospitals  were  broken  up,  just  a  few  days  .before  the  battle  of  Chancellors- 
ville,  there  remained  under  treatment  about  twenty  cases,  that  were  sent  to  general  hos¬ 
pital  at  Richmond. 

To  Surgeon  Todd,  wre  are  indebted  for  the  following  facts,  that  were  embodied  in  a 
report  made  by  myself  to  Surgeon  Robert  J.  Breckinridge,  Medical  Inspector  of  the  army. 

To  the  man  above  alluded  to,  who  returned  to  his  command  shortly  after  the  battle  of 
Fredericksburg,  was  traced  the  origin  of  the  vaccine  virus  that  had  wrought  so  much 
mischief  in  the  two  Georgia  brigades.  He  stated  that  on  his  way  back  to  the  army,  that 
he  was  detained  in  Augusta,  Ga. ,  and  whilst  there  visited  a  house  of  ill-fame,  and  was 
vaccinated  by  one  of  the  female  inmates.  This  man  denied  ever  having  had  syphilis  pre¬ 
vious  to  his  vaccination.  The  rupia  looking  sore  on  his  arm,  and  roseolous  eruption  of 
the  skin  of  a  coppery  hue,  added  to  the  fact  that  others  vaccinated  from  the  sore  pre¬ 
sented  many  of  the  characteristic  features  of  constitutional  syphilis,  are  to  my  mind  un¬ 
mistakable  evidences  that  syphilis  may  be  communicated,  I  will  not  say  by  vaccine  lymph, 
but  certainly  by  vaccination  ;  possibly  by  getting  a  small  quantity  of  blood  on  the  point 
of  the  lancet  m  performing  the  operation. 

I  am  unable  to  say  whether  the  woman  by  whom  this  man  was  vaccinated  had  syphilis 
or  not. 

In  thinking  of  this  subject,  the  thought  suggests  itself  to  my  mind,  that  if  the  blood 
can  convey  a  poison,  that  the  vaccine  lymph  would  be  equally  as  capable ;  for  if  there  is 
anything  in  our  theories  about  cells,  and  especially  if  the  cells  have  an  individual  exist- 
ance,  certainly  it  is  fair  to  presume,  that  any  cell  that  has  its  existance  from  a  person 
suffering  from  a  constitutional  disease,  might  have  imparted  to  it  the  disease  of  the  parent. 
In  no  other  way  can  we  account  for  the  transmission  of  disease  from  father  to  child ;  and 
then  again  the  query  arises,  if  the  blood  can  be  poisoned  by  a  disease  of  the  cells,  why 
may  not,  the  other  fluids  be  also?  But  this  is  theorizing  and  we  are  after  facts,  and  I 
think  that  my  experience  will  sustain  me,  in  the  assertion,  that  syphilis  may  be  commu¬ 
nicated  by  vaccination.  I  am  not  prepared  to  say  that  its  transmissibility  is  not  due  to 
a  small  quantity  of  blood  that  happens  to  get  on  the  point  of  the  instrument,  when  the 
operation  is  performed,  by  inserting  the  virus  directly  from  the  arm  of  another,  or  by  a 
small  quantity  that  happens  to  get  on  the  crust  when  removed  ;  but  I  am  forced  to  con¬ 
clude  that  I  can  see  no  reason  why  vaccine  lymph  cannot  as  well  be  the  vehicle  of  contu¬ 
sion  as  blood  itself. 

The  testimony  of  a  distinguished  member  of  our  profession  is  strong  in  proof,  that  syph¬ 
ilis  may  be  communicated  by  the  blood,  who  affirms  that  he  had  constitutional  syphilis 
from  a  poisoned  wound  got  from  operating  after  the  battle  of  Shiloh.  *  *  * 

Yours,  truly,  J.  T.  GILMORE, 

J)r.  James  Bolton,  in  tlie  report  from  which  we  have  already  introduced 
valuable  facts  relative  to  the  history  and  origin  of  u  spurious  vaccination,” 
in  the  Confederate  army ,  held  that  besides  these  cases  which  were  referable  to 
the  imperfect  nature  of  the  vaccine  matter  and  to  the  unhealthy  condition 
of  the  system,  and  to  the  development  of  latent  diseases,  others  occurred 
of  a  far  more  formidable  character. 

Dr.  James  Bolton  testified  : 

So  great  was  the  dread  of  the  small-pox  in  the  army,  that  the  men  became  impatient 
of  the  slow  process  of  vaccination  by  medical  officers  with  carefully  selected  virus.  Com¬ 
mon  soldiers  and  even  officers  became  zealous  operators.  The  more  powerful  the  local 
action  the  more  effectual  was  the  protection  supposed  to  be,  and  “large  sores  were  in 
great  request.”  In  a  short  time  the  most  terrible  consequences  ensued.  Large  numbers 


Spurious  Vaccination:  Joseph  Jones.  M.  D. 


335 


of  men  were  unfit  for  duty.  The  attention  of  medical  officers  was  called  to  a  wide  spread 
truly  contagious  disease.  On  careful  inspection  the  ulcers  presented  the  various  appear¬ 
ance  of  genuine  chancre.  In  some  instances  there  was  the  elevated,  cartilaginous,  well 
cut  edge  surrounding  the  indolent,  greenish  ulcer;  in  others  there  was  a  burrowing  ulcer, 
with  ragged  edge;  in  others  there  was  the  terrible  destructive  sloughing  process  devas¬ 
tating  the  integuments  of  the  arm.  Many  of  these  cases  were  so  situated  that  their  his¬ 
tory  could  be  preserved,  and  in  these  secondary  symptoms  appeared,  followed  in  due  time 
by  tertiary  symptoms,  The  chancre  was  followed  successively  by  axillary  bubo,  sore 
throat,  and  various  forms  of  eruption,  (sy philo  dermata),  while  the  system  fell  into  a 
state  of  cachexia.  Finally,  previous  vaccination  did  not  protect  against  this  disease.  In 
short,  the  disease  was  genuine  syphilis. 

Whence  its  origin?  So  far  as  was  ascertained  by  strict  inquiry  it  had  in  no  case  been 
propagated  by  a  medical  officer.  In  these  instances  there  was  no  case  of  true  vaccinia 
followed  by  syphilis.  When  first  seen  it  was  true  syphilis,  and  it  never  presented  any 
other  phenomena  than  those  of  this  foul  disease.  This  was  true  of  all  cases;  the  phe¬ 
nomena  were  those  of  true  syphilis  from  its  inoculation  to  its  development,  on  to  its 
termination.  There  was,  therefore,  no  evidence  of  the  contamination  of  vaccine  virus 
by  that  of  syphilis. 

The  results  of  treatment  also  corresponded  with  this  view  of  the  disease.  The  mercu¬ 
rial  treatment  was  the  only  one  which  could  be  relied  upon.  On  account  of  the  scor¬ 
butic  condition  of  many  of  the  patients  it  was  necessary  to  use  mercury  with  great  cau¬ 
tion,  and  the  alterative  use  of  the  bi-chloride  of  mercury  was  best  Adapted  to  the  gener¬ 
ality  of  these  cases. 

The  question  remains.  Whence  the  origin  of  this  disease  in  the  army  ?  It  prevailed 
most  extensively  among  the  troops  from  the  State  of  Georgia,  and  it  was  thought  to 
have  been  traced  to  a  soldier  from  that  State,  who  had  returned  home  on  furlough,  and 
who  was  said  to  have  vaccinated  himself  from  his  wife.  It  was  also  reported  that  there 
were  many  cases  of  this  form  of  disease  in  the  neighborhood  of  his  home. 

Another  source  of  this  disease  was  said  to  have  been  traced  to  the  person  of  a  highly 
respectable  lady  residing  in  the  neighborhood  of  Danville,  Virginia. 

Finally,  a  third  source  was  thought  to  have  been  traced  to  Culpeper  county,  Virginia. 

All  these  accounts  of  the  disease,  however,  are  exceedingly  indefinite  and  unreliable. 
In  fact,  they  may  have  been  given  by  some  of  the  men  in  order  to  conceal  the  really  im¬ 
pure  origin  of  the  disease. 

The  following  propositions  may  then  be  fairly  deduced  as  a  resumd  of  the  foregoing 
facts  and  remarks : 

1.  That  in  some  instances  pure  vaccine  virus  being  introduced  into  a  scorbutic  system, 
or  one  deranged  by  some  other  cause,  e.  g.,  epidemic  influence,  an  aberration  of  the 
phenomena  of  vaccinia  was  produced,  but  the  patient  was  protected  from  variolous  con¬ 
tagion. 

2.  It  is  highly  probable  that  concrete  pus,  or  some  other  morbid  animal  product  was 
used,  and  that  it  produced  local,  eliminative  inflammation,  with  some  degree  of  consti¬ 
tutional  disturbance.  In  these  instances  there  was  of  course  no  consequent  protection. 

3.  In  very  many  cases  there  was  true  syphilitic  inoculation.  In  these  cases  the  virus 
was  unmixed  with  that  of  vaccinia.  Its  source  was  purely  syphilitic.  Here  again  there 
was  no  protection. 

From  these  propositions  there  result  the  following  corollaries  : 

1.  Vaccinations  should  only  be  performed  by  educated  physicians,  except  in  case  of 
necessity,  aud  then  by  carefully  instructed  persons,  under  their  observation.  Vaccina¬ 
tions  of  themselves  and  of  each  other,  by  soldiers  should  be  strictly  prolnbitted. 

2.  Vaccine  virus  should  be  carefully  selected  from  healthy  persons  in  whom  the  disease 
was  known  to  have  run  a  normal  course. 

3.  Except  in  case  of  necessity,  vaccination  should  not  be  performed  when  the  system 
of  the  subject  is  in  an  unhealthy  condition. 

4.  Except  in  case  of  absolute  necessity,  vaccination  ought  not  to  be  performed  when 
there  is  an  epidemic  influence  prevailing  which  predisposes  to  erysipelas  or  other  con¬ 
generic  diseases. 


APPENDIX  TO  DR.  BOLTON’S  PAPER  ON  SPURIOUS  VACCINA¬ 
TION  AS  IT  APPEARED  IN  THE  LATE  CONFEDERATE  ARMY. 

In  a  paper  on  spurious  vaccination,  as  it  occurred  in  the  late  Confederate  Armies,  I 
stated  that  my  original  paper,  and  the  original  sources  of  information,  having  been 
destroyed,  I  was  compelled  to  write  from  memory,  and  was  unable  to  verify  my  remarks 
by  quotations.  Since  then  I  have  discovered  some  fragments  of  the  rough  draft  of  my 
original  paper,  containing  several  abstracts  of  army  reports,  I  therefore  respectfully 
present  these  by  way  of  appendix  to  the  paper  recently  read  before  the  Academy,  only 
regretting  that  these  abstracts  are  so  meager. 


336 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


Surgeon  Habersham,  in  charge  of  the  second  division  of  Chimborazo  Hospital,  presented 
an  elaborate  report  upon  a  large  number  of  cases  of  spurious  vaccinia  which  came  under 
his  care.  He  states  that  in  obedience  to  an  order  from  the  Surgeon-General,  he  vaccina¬ 
ted  all  the  soldiers  as  they  were  admitted.  Instead  of  the  usual  phenomena  of  vaccinia, 
a  spurious  form  of  disease  appeared,  which  he  thus  describes:  > 

“A  few  days  after  the  insertion  of  the  virus,  and  in  many  cases  within  twenty-four 
hours,  the  seat  of  the  puncture  became  very  much  inflamed,  with  a  deep  red  inflamma¬ 
tory  blush  around  it,  which  gradually  implicated,  in  the  severe  cases,  nearly  the  whole 
of  the  affected  limb.”  A  pustule  rapidly  formed  instead  of  a  vesicle,  wTiich  soon  dis¬ 
charged  an  ichorous  fluid.  This  fluid  was,  in  the  course  of  forty-eight  hours,  converted 
into  a  dark  mahogany-colored,  irregularly-shaped  pliagadenic  ulcer,  with  everted  edges, 
presenting  the  appearance  of  a  syphilitic  ulcer.  There  was  also  more  or  less  pyrexia  and 
loss  of  appetite.  In  these  highly  aggravated  cases,  successive  crops  of  pustules  appeared 
upon  the  upper  and  lower  limbs,  but  never  upon  the  head  and  trunk. 

He  observed  three  grades  of  the  disease  differing  in  degrees  of  malignancy.  Thinking 
these  results  may  have  been  due  to  the  impurity  of  the  virus,  he  cast  it  aside,  and  ob¬ 
tained  some  of  a  highly  respectable  civil  practitioner,  accompanied  with  the  assurance 
that  it  had  been  “used  in  several  cases  with  a  perfect  result.  The  introduction  of  this 
virus  into  the  arms  of  some  ten  patients,  resulted  in  development  of  the  disease  in  ques¬ 
tion  in  three  of  them,  while  in  the  remainder  it  produced  apparently  a  true  pustule. 
From  this  fact,  and  the  immunity  which  healthy-looking  men  enjoyed,  I  was  led  to  be¬ 
lieve  that  the  predisposing  cause  existed  in  a  vitiated  and  impoverished  condition  of  the 
blood.  There  was  no  evidence  to  show  that  its  origin  was  syphilitic.” 

Surgeon  H.  regarded  the  disease  as  a  consequence  of  “  an  impoverished  condition  of 
blood,  being  deficient  in  fatty  matter.”  Accordingly  he  treated  his  cases  by  supplying  a 
rich  nutritious  food,  by  the  judicious  use  of  alteratives,  and  by  the  administration  of 
cod-liver  oil.  He  states  that  a  large  supply  of  this  oil  was  received  in  the  early  part  of 
August,  and  that  by  the  nineteenth  of  the  same  month  many  were  well  enough  to  rejoin 
their  commands.  The  oil  was  used  internally  and  locally.  He  arrives  at  the  following 
conclusions  : 

1.  That  the  disease  is  pustular  and  resembles  ecthyma. 

2.  That  it  is  a  local  manifestation  of  a  general  disorder  or  vitiated  condition  of  the 
blood. 

3.  That  this  vitiated  condition  resulted  from  impure  and  spare  diet,  together  with  in¬ 
attention  to  cleanliness. 

4.  That  syphilitic  virus  had  no  influence  in  producing  the  disease. 

5.  That  the  effects  were  not  produced  by  any  impurity  in  the  vaccine  virus. 

6.  That  the  disease  can  be  removed  by  those  means  only  which  are  calculated  to  improve 
the  general  condition  and  restore  the  healthy  play  of  all  the  functions. 

W.  S.  Mitchell.  Chief  Surgeon  of  Rodes’  Division,  thus  reports  a  spurious  vaccinia 
which  appeared  in  January,  1863.  Inflammation  occurred  within  twenty-four  hours 
after  inoculation.  In  two  or  three  days  a  vesicle  was  formed  which  was  soon  followed 
by  pustulation.  Some  observers  state  that  the  eruption  was  pustular  from  the  very  be¬ 
ginning.  The  ulcers  were  covered  with  thick  scabs  having  a  tendency  to  renewal.  The 
ulcers  were  dry  and  many  had  indurated  edges  with  little  disposition  to  granulate  and 
presented  a  tawney  grey  color  resembling  the  Hunterian  chancre.  The  hundred  and 
twenty-seven  cases  which  occurred  in  the  Forty-Fourth  Georgia  Regiment,  were  derived 
from  one  man  who  was  inoculated  from  his  wife,  in  Georgia.  Many  similar  cases  were 
reported  as  having,  occurred  in  that  State.  Some  cases  yielded  to,  and  some  resisted 
treatment.  Some  were  treated  with  mercury,  and  some  with  iodide  of  potash,  with  little 
advantage. 

The  best  treatment  consisted  in  keeping  the  ulcers  clean  and  applying  nitrate  of  silver. 
Many  cured  in  this  way  showed  a  tendency  to  return.  The  disease  could  not  have  been 
due  to  canstitutional  vice,  as  the  subjects  were  all  previously  healthy.  It  was  evident 
that  the  constitution  was  subsequently  involved,  as  all  recotmred  during  the  Maryland 
and  Pennsylvania  campaigns.  Two  hundred  and  forty  cases  left  Fredericksburg,  all  of 
which  recovered  on  the  march.  It  was  evidently  not  followed  by  constitutional  symp¬ 
toms.  Many  similar  reports  were  made  by  surgeons  of  other  divisions. 

Surgeon  Read,  in  charge  of  the  Officers’  Hospital,  Richmond,  Virginia,  states  that  a 
number  of  cases  came  under  his  care  which  resisted  treatment  while  at  hospital,  but  that 
all  recovered  on  being  sent  to  their  homes. 

The  reports  of  Surgeons  Habersham  and  Read  evidently  refer  to  a  class  of  cases  not 
of  syphilitic  character.  Some  of  Surgeon  Mitchell’s  cases,  which  were  not  fully  traced 
out  by  him,  may  have  proved  syphilitic  when  fully  developed.  All  those  which  continued 
to  be  under  his  observation  seem  not  to  have  been  syphilitic.  Even  this,  however,  is  not 
perfectly  clear.  The  history  of  the  disease  is  certainly  very  suspicious.  The  patients 
were  previously  healthy,  and  the  local  results  resembled  strongly  those  of  syphilitic  in¬ 
oculation.  The  constitution  was  evidently  involved,  but  neither  secondary  nor  tertiary 
symptoms  were  devloped  so  long  as  they  were  under  his  observation,  and  the  patients  re- 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


337 


covered  without  the  use  of  what  is  commonly  understood  by  anti-syphilitic  treatment. 
These  facts,  however,  will  not  be  regarded  by  every  one  as  conclusive,  for  it  will  not  be 
denied  that  syphilis  may  be  cured  without  mercury  We  are  not  informed  how  long 
these  cases  continued  under  Surgeon  Mitchell’s  observation,  and  secondary  symptoms 
may  have  subsequently  appeared  in  some  of  them.  Without  his  knowledge,  Surgeon 
Breckinridge  investigated  the  disease  as  it  came  under  his  observation,  and  carefully  ex¬ 
amined  the  reports  of  surgeons  transmitted  to  him  in  compliance  with  orders.  He  con¬ 
cludes  “that  the  disease  was  essentially  syphiloid,  and  in  respect  as  a  whole  resembled 
in  its  incipiency,  progress  or  termination,  the  genuine  vaccine  disease.  The  army  was 
generally  in  good  health.  There  was  some  tendency  to  scurvy,  but  no  connection  could 
he  traced  between  the  disease  and  this  condition. 

In  many  cases  there  were  no  evidences  of  a  scorbutic  condition.  The  subjects  were 
generally  in  robust  and  vigorous  health.  There  was  no  case  in  which  I  had  reason  to  be¬ 
lieve  that  any  antecedent  constitutional  vice,  either  inherited  or  acquired,  exercised  the 
slightest  influence  in  developing  or  modifying  the  disease.  Previous  vaccination  failed  to 
afford  any  protection  asrainst  it  ” 

Surgeon  A.  H.  Powell’s  report: 

A  driver  vaccinated  a  soldier  from  liis  own  arm  on  the  eighth  day  from  the  date  of  his  own  vaccination. 
Two  or  three  days  after  there  appeared  at  the  place  of  the  insertion  of  the  virus  a  suppurating  ulcer,  fol¬ 
lowed  by  large  unhealthy  ulcers  on  the  arm  which  did  not  heal  for  six  months.  These  ulcers  were  accom¬ 
panied  by  an  enlarged  gland  in  the  axilla.  The  soldier  had  two  ulcers,  a  large  one  at  the  point  of  vaccina¬ 
tion  and  another  on  the  back  of  the  hand.  Several  others  were  inoculated  with  the  same  virus  and  with  like 
results.  Nothing  was  known  of  its  origin. 

Abstract  of  the  report  of  Surgeon  J.  A.  Etheridge : 

Three  hundred  and  thirty-two  occurred  in  Dale’s  Brigade,  beginning  as  early  as  January.  Inflammation 
commenced  twenty -four  hours  after  inoculation.  A  vesicle  appeared  in  two  or  three  days,  but  in  some  in¬ 
stances  the  eruption  was  pustular  from  the  first.  These- were  followed  by  ulcers  covered  with  thick  scabs. 
The  ulcer  closely  resembled  the  Hunterian  chancre.  Two  hundred  and  twenty-seven  cases  occurred  in  the 
Forty- fourth  Georgia  Regiment.  and  the  virus  in  all  these  cases  was  derived  from  one  man.  He  stated  that 
he  was  vaccinated  from  his  wife’s  arm  while  at  home  on  furlough,  and  that  there  were  other  cases  in  the 
same  neighborhood.  All  the  cases  in  the  Twelfth  Georgia  Regiment  were  inoculated  with  virus  derived 
from  the  Forty-fourth  Georgia  Regiment.  All  cases  in  the  Twenty-first  Georgia  Regiment,  with  few  excep¬ 
tions,  were  derived  from  the  same  source.  The  cases  in  the  Fourth  Georgia  Regiment  were  derived  from  a 
scab  obtained  from  the  chief  surgeon  of  the  division. 

Treatment . — Some  were  cured  by  the  topical  application  of  nitrate  of  silver,  some  stimulating  lotions  and 
others  by  ointments .  Some  were  treated  by  the  internal  use  of  mercury  and  iodide  of  potash, but  with 
little  benefit.  The  best  remedies  seemed  to  be  nitrate  of  silver  locally  applied,  and  cleanliness.  In  many 
cases  there  was  a  tendency  to  return. 

Cause. — The  disease  could  not  have  been  due  to  an  impoverished  condition  of  the  blood,  as  it  occurred  in 
some  who  had  just  returned  from  furlough,  and  were  in  high  health.  Although  the  disease  was  not  caused 
by  constitutional  vice,  yet  some  vice  must  have  existed  at  the  time,  protracting  the  disease  and  interfering 
with'  the  cure,  since  all  recovered  during  the  Pennsylvania  and  Maryland  campaign.  Two  hundred  and 
forty  cases  existed  when  the  army  left  Fredericksburg,  and  all  recovered  on  the  march.  Although  he,  at 
first,  suspected  it  to  be  syphilitic,  he  was  afterwards  satisfied  that  it  was  not.  No  secondary  symptoms  oc¬ 
curred,  and  all  recovered  on  the  march.  At  the  same  time  there  must  have  been  some  constitutional  vice, 
from  the  disease  breaking  out  after  being  apparently  cured. 

Abstract  of  Report  of  Surgeon  Hicks  : 

Perfectly  pure  virus  was  mixed  with  some  whose  history  was  unknown.  This  mixture  produced  vesi¬ 
cles  which  soon  became  pustular;  in  no  other  instances  it  produced  pustules  from  the  beginning.  The 
suppuration  was  so  profuse  that  no  scab  was  formed  for  two  or  three  weeks.  After  several  successive 
scabs,  the.ulcer  healed,  leaving  a  purple  cicatrix.  These  sores  were  frequently  accompanied  by  others  upon 
the  extremities  only.  There  were  no  constitutional  symptoms.  Iu  a  few  cases  there  was  debility. 

Treatment. — Some  were  treated  with  mercury,  some  with  iodide  of  potash  internally,  and  nitrate  of  silver 
locally;  some  were  treated  with  cold  water  locally  and  generally.  The  cold  water  treatment  succeeded 
best.  Anti-syphilitic  treatment  failed  entirely.  The  worst  cases  were  sent  to  General  Hospital,  and  the 
others  went  with  the  army.  All  of  the  latter  recovered  speedily.  With  a  few  exceptions,  all  sent  to  the 
hospital  recovered,  but  required  two  or  three  months’  longer  treatment.  In  one  case  a  sere  above  the  ankle 
healed  under  the  local  application  of  bruised  stramonium  leaves. 

Cause. — It  was  not  scorbutic,  because  scurvy  cannot  be  inoculated.  The  officers  and  men,  whether  they 
had  been  at  home  or  had  remained  in  camp,  whether  they  used  scorbutic  or  anti-scorbutic  diet,  were  equally 
obndxious  to  it.  Scorbutic  diet  will  prolong  it.  It  does  not  protect  the  system  against  small-pox.  It  may 
be  reproduced  any  number  of  times  on  the  same  individual,  no  matter  how  far  advanced  the  sore  maybe. 
A  hospital  nurse,  insusceptible  of  vaccinia,  was  readily  inoculated  with  this  virus.  It  was  not  syphilitic, 
because  it  did  not  present  the  appearance  of  syphilis  and  did  not  yield  to  anti-syphilitic  treatment,  which 
served  rather  to  prolong  the  disease.  No  secondary  symptoms  were  observed.  It  resembles  rupia,  but 
this  cannot  be  inoculated. 

Abstract  of  Surgeon  HaigMll’s  report : 

A  soldier  was  vaccinated  on  the  fifth  of  April.  His  arm  was  healed  by  the  first  of  May,  when  a  large 
ulcer  appeared  on  one  of  his  ankles.  On  the  seventh  of  May,  he  complained  of  sore  throat,  and  appeared 
to  have  secondary  syphilis. 

Treatment.— Iodide  of  potash  internally  anu  lunar  caustic  locally.  A  general  improvement  took  place 
under  this  treatment,  but  the  ulcers  had  not  healed  on  the  ninth  of  September,  more  than  four  months  after 
the  first  appearance  of  the  disease. 

Abstract  of  Surgeon  Rutlierford’s  report : 

In  nineteen  out  of  twenty  cases  the  virus  (lymph  1)  was  taken  from  the  arm  of  a  comrade  by  some  soldie  r 
or  officer,  and  not  by  a  surgeon,  without  reference  to  the  period  after  vaccination  Matter  was  often  taken 


338 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


from  beneath  a  scab.  Of  course  this  was  true  pus  and  not  lymph.  The  only  case  following  the  use  of  a 
scab  resulting  in  malignant  ulcer  occurred  in  Jeffrey’s  Battery.  The  scab  appeared  to  be  derived  from  a 
secondary  vaccination,  f  rom  a  limited  experience,  he  concluded  that  the  disease  was  due  to  the  introduc¬ 
tion  of  pus  into  the  system . 

Professor  Paul  P.  Eve,  M.  D.,  of  the  Medical  Department  of  the  Univer¬ 
sity  of  Nashville,  as  will  be  seen  in  the  following  quotation  from  his  article 
“  On  the  Health  of  the  Southern  Army,”  believes  that  syphilis  may  be  trans¬ 
mitted  by  vaccination. 

“  Syphilis  in  Connection  with  Vaccination. — From  all  I  have  heard  and  read  on  the  trans- 
missibility  of  syphilis  by  vaccination,  the  question,  from  the  evidence  already  accumu¬ 
lated,  would  appear  decided  in  the  affirmative.  While  I  have  seen  nothing  confirming 
this  opinion,  yet  I  do  know  that  cases  did  occur  in  Richmond,  Va.,  said  to  be  corrobora¬ 
tive  of  it,  and  that  medical  officers  in  the  Southern  service  were  specially  cautioned  as  to 
the  sourse  whence  vaccine  matter  was  derived.  Since  my  return  to  Nashville,  I  find  that 
in  some  instances  syphilitic  diseases  have  been  definitely  traced  to  the  insertion  of  vac¬ 
cine  matter.  My  colleague,  Dr.  Briggs,  called  my  attention  recently  to  a  case  of  this 
kind,  the  source  of  which  he  entertains  no  doubt.  I  failed  to  see  it,  as  the  patient  had 
left  for  the  Hot  Springs  of  Arkansas.  When  told  that  he  had  secondary  symptoms  of 
syphilis,  he  replied  that  it  was  impossible,  as  he  had  never  contracted  the  primary,  though 
confessing  that  he  was  almost  daily  exposed  to  it.  Two  other  physicians  were  cousulted 
as  to  the  affection,  and  from  this  history  of  the  case  were  inclined  to  the  belief  of  the 
patient,  but  stated  it  looked  like  venereal.  It  was  subsequently  ascertained  that  this 
person  had  been  vaccinated  from  a  girl  of  the  town  who  labored  under  constitutional 
syphilis.  Not  only  was  the  arm  very  sore,  but  buboes  formed  in  the  axilla,  followed  by 
ulcerations  in  the  throat,  copper  blotches  in  the  skin,  nodes,  etc. 

“The  possibility  of  communicating  syphilis  by  vaccination,  was  agitated  in  Italy  as  far 
back  as  1846  ;  and  the  trausmissibility  of  this  unfortunate  contamination  was  there  de¬ 
finitely  admitted  in  1861,  by  a  committee  elected  at  a  Medical  Congress  at  Acqui  in 
Piedmont,  at  which  it  was  believed  that  numerous  cases  had  occurred  in  both  children 
and  adults,  who  had  been  vaccinated.  The  names  of  Pacchiotti,  Parola,  Ponza,  Tassani, 
of  Milan,  who  I  met  there  in  charge  of  a  large  hospital  after  the  battle  of  Magenta  and 
Solferino,  in  1859,  De  Ivalt,  Hubner,  etc.,  vouch  for  the  accuracy  of  this  report.  The 
transmission  of  (syphilitic)  disease  has  also  been  maintained  by  Lecoq,  Rollet  of  Lyons, 
and  particularly  by  Vennois  in  the  Archives  Gfinffiales  de  Paris,  1860;  and  on  this  point, 
the  admission  of  Dr.  D.  F.  Condie,  long  known  to  occupy  the  front  rank  in  the  profes¬ 
sion,  and  who  has  done  so  much  for  its  literature,  deserves  serious  consideration  ;  and  he 
publishes  these  words  in  a  recent  number  of  the  American  Journal  of  Medical  Sciences  : 

‘“Let  it  be  strongly  impressed  upon  the  mind  of  every  physician,  lest  in  his  attempt  to 
guard  the  system  against  one  formidable  malady,  he  inoculate  with  another,  more  in¬ 
sidious  in  its  operations,  but  not  less  destructive.’ 

“As  to  the  consentaneous  presence  of  two  constitutional  diseases  in  the  same  patient, 
and  the  contagiousness  of  secondary  symptoms  of  syphilis,  it  is  sufficient  for  us  to  state 
that  at  a  recent  meeting  of  the  Academy  of  Medicine  in  Paris,  the  report  from  a  com¬ 
mittee,  on  which  MM.  Velpeau  and  Ricord  served,  (than  whom  it  may  be  safely  asserted 
two  better  names  for  this  very  purpose  never  existed  in  the  annals  of  the  profession), 
decided  both  these  questions  in  the  affirmative.” 

Dr.  O.  Kratz,  in  the  following’  report  to  the  Surgeon  General  on  vaccina¬ 
tion,  originally  published  in  the  July  number  of  the  Confederate  States 
Medical  and  Surgical  Journal  (vol.  1,  1864,  p.  104),  supported  the  view  that 
secondary  syphilis  could  be  communicated  through  the  medium  of  vaccine 
virus. 


OK  VACCINATION  AND  VAKIOLOUS  DISEASES.  BY  O.  KEATZ, 

SUEGEON,  P.  A.  C.  S. 

The  following  remarks  on  vaccination  and  variolous  diseases  have  been  suggested  to 
me  from  my  own  experience.  Spurious  vaccine  and  its  deleterious  influence  on  vaccin¬ 
ation,  seem  to  me  worthy  of  further  investigation  as  a  subject  hitherto  not  sufficiently 
appreciated. 

In  order  to  define  my  stand-point,  let  me  state,  at  the  outset,  that  Liebig’s  Theory  of 
Fermentation  is,  till  now,  the  best  to  explain  the  pbeuomena  of  vaccination,  and  that 
all  the  anomalies  occurring  may  be  best  elucidated  by  this  hypothesis.  At  the  same  time 
I  do  not  feel  warranted  in  subscribing  blindly  to  it ;  but  I  think  we  have  not  any  better 
as  yet,  and  I  simply  adopt  it  in  the  same  manner  as  I  would  have  to  conform  to  the 
atomic  theory  in  treating  about  chemistry. 


Spurious  Vaccination :  Joseph  Jones ,  M.  I). 


339 


In  vaccinating  a  subject,  we  introduce,  then,  the  yeast — the  virus — into  the  circula¬ 
tion,  to  produce  the  fermentation  and  its  result  ,  the  seal).  ]f  there  is  a  certain  substance 
in  the  system  for  the  virus  to  react  upon,  the  scab  will  be  formed,  and  the  subject  is  vac¬ 
cinated.  If,  on  the  contrary,  this  substance  is  entirely  dehcient  or  modified  in  some  way 
or  other,  no  scab,  or  an  imperfect  one,  will  be  the  result. 

With  very  few  exceptions  the  good  vaccine  matter  will  produce  a  normal  scab  on  the 
subject  never  vaccinated  before.  The  reacting  matter  in  the  system  is  eliminated  and 
by  this  process  the  liability  to  the  infection  of  small-pox  rendered  impossible  or  greatly 
diminished.  Possibly,  in  a  long  interval  of  time,  this  matter  may  be  reorganized  in  the 
body,  but  never  to  its  original  state. ^  (I  say  never,  because  such  a  subject  may  be  at¬ 
tacked  by  varioloides,  but  never  by  variola. 

If  this  reacting  matter  is  reorganized  as  nearly  as  possible  to  its  original  state,  the  sec¬ 
ond  vaccination  will  produce  a  scab  also,  but  never  a  perfect  one.  It  may  be  perfect  for 
the  protection  of  the  individual  on  whom  it  appears,  but  it  offers  no  guarantee  for  revac¬ 
cination  on  other  subjects.  I  call  this  a  pseudo-scab.  This  scab  may  yet  retain  much  of 
the  original  fermenting  property,  but  not  the  same  as  the  genuine.  If  this  virus  is  used 
again  for  revacciuation  of  an  individual,  its  product  will  offer  again  less  guarantees  of 
being  protective.  Continuing  in  this  manner  the  scab  will  finally  contain  nothing  but 
common  suppurati  ve  matter — pus — as  if  taken  from  any  other  suppurating  place  in  the 
body.  The  germ  of  the  scab  itself  will  be  more  or  less  modified  and  deviating  from  its 
normal  structure. 

As  I  have  no  book  of  reference  on  the  subject,  I  quote  the  following  from  memory  : 

Some  years  ago,  the  Academy  of  Science  iu  Paris  investigated  very  closely  the  fact,  if 
syphilis'could  be  transferred  by  vaccination.  The  result  obtained  by  repeated  and  most 
direct  experiments  was,  that  it  could  not  be  communicated  by  transmission  of  genuine 
vaccine  virus,  from  one  individual  to  another,  affected  with  syphilis  in  any  of  its  stages. 
Liebig’s  explanatory  theory  of  fermentation  holds  good  here.  The  vacoine  virus  will  re¬ 
act  only  on  certain  substances  in  the  system  and  ignore  others  entirely.  We  know,  at 
the  same  time,  that  matter  from  asyphilitic  suppurating  surface  will  reproduce  syphilitic 
symptoms  on  another  subject. 

I  have  had  occasion  to  observe  several  well  defined  cases  of  Rupia  Syphilitica  produced 
solely  by  vaccination.  Other  respectable  surgeons,  worthy  of  implicit  belief,  from  their 
scientific  attainment,  have  noticed  the  same  and  similar  facts  repeatedly. 

These  subjects  had  never  syphilis  before,  otherwise  the  inference  would  have  been 
doubtful  or  worthless  altogether.  Therefore,  instead  of  having  had  vaccine  virus  in¬ 
serted,  they  have  been  inoculated  with  syphilis. 

I  have  seen  one  case,  where  the  product  of  the  vaccination  was  serpetigo  rodehs,  a 
frightful  disease  of,  I.  believe,  cancerous  character.  Some  cases  had  herpes  excedens  as 
the  result  of  vaccination  on  their  arm. 

The  syphilitic  cases  had  been  treated  for  other  cutaneous  diseases  without  any  mate¬ 
rial  amelioration.  The  mercurial  treatment  removed  the  symptoms  at  once. 

I  have  never  seen  anomalous  results  from  vaccination,  if  the  following  precaution  was 
strictly  adhered  to:  The  vaccine  matter  used  was  taken  from  a  healthy  infant,  never 
vaccinated  before. 

The  indiscriminate  vaccination  and  re-vaccination  from  arm  to  arm  has  been,  in  my 
opinion,  the  principal  cause  of  the  deterioration  of  the  vaccine  virus,  and  of  producing 
cutaneous  diseases  from  vaccination.  A  second  cause  may  be  found  in  the  fact  that  the 
virus  used  is  old  and  too  rarely  regenerated  by  passing  it  through  the  cow.  Cow  virus 
will  fail  only  1  in  100;  good  common  virus  will  fail  3  in  100,  if  I  remember  right. — Con¬ 
federate  States  Medical  and  Surgical  Journal,  July,  1864. 

The  testimony  of  Dr.  Wm.  F.  Fuqua,  of  Virginia,  formerly  surgeon  of 
the  Seventh  Florida  Regiment,  C.  S.  A.,  is  clear  and  decided.  Fifty-two 
Confederate  soldiers,  who  had  been  inoculated  with  virus  from  the  arm  of 
a  sailor  who  was  laboring  under  syphilis,  presented  the  characteristic 
symptoms  of  constitutional  syphilis,  as  abscesses  in  the  axillary  glands, 
pain  in  the  limbs  and  joints,  sensation  of  dryness  and  ulceration  in  the 
throais,  buboes,  coppery  colored  spots,  and  loss  of  hair,  and  they  were  only 
relieved  by  syphilitic  treatment.  If  these  results  of  vaccination  had  been 
due  to  a  depressed  and  scorbutic  state  of  the  blood,  the  syphilitic  mercurial 
treatment,  would  have  greatly  aggravated  the  diseased  condition. 


340 


Spurious  Vaccinatio7i :  Joseph  Jones ,  M.  D. 


ON  THE  COMMUNICABILITY  OF  SYPHILIS  BY  VACCINATION. 
BY  WM.  M.  FUQUA.,  M.  D.,  APPOMATOX  COUNTY,  VA. 

On  assuming  charge  of  the  Seventh  Florida  Regiment,  late  C.  S.  A.,  as  medical  officer, 

1  found  fifty-two  men,  who  had  been  recently  vaccinated,  suffering  from  severe  ulcers  on 
their  arms  at  the  site  of  vaccination.  Some  of  these  ulcers  had  scabbed,  and  to  all  ap¬ 
pearances  seemed  to  promise  a  speedy  “  return  to  duty.”  There  were  others  varying  in 
size  from  that  of  a  quarter  of  a  dollar  to  that  of  a  Mexican  dollar.  Their  edges  were 
hard,  shining  and  everted  ;  in  some  few  cases  they  were  undermined.  An  ashy-colored 
slough  covered  their  base,  which  was  from  time  to  time  cast  off.  This,  however,  was  not 
always  a  genuine  slough,  but  a  tenacious  gray  and  partially  organized  exudation.  These 
ulcers  were  offensive,  and  discharged  pus  freely.  The  redness  circumscribing  them  was 
limited,  the  limb  but  little  swollen,  and  the  pain  of  a  burning,  stinging  character.  In 
many  instances  the  lymphatic  vessels  were  much  inflamed,  and  the  axillary  glands  in 
each  case  were  more  or  less  affected.  Many  of  these  patients  complained  of  pain  in  their 
limbs  ;  there  was  some  febrile  excitement,  and  their  appetites  had  been  much  impaired. 
Having  thus  briefly  described  these  ulcers,  it  may  not  be  improper  to  remark  upon  the 
hygienic  condition  of  the  regiment. 

At  this  time,  it  was  doing  duty  at  Knoxville,  in  the  department  of  East  Tennessee,  and 
was  quartered  a  mile  from  town,  upon  soil  which  had  been  previously  occupied  by  troops, 
who  had  left  the  encampment  in  no  praiseworthy  condition.  To  the  south,  southwest 
and  west,  passed  the  Holston  river.  The  general  health  of  the  command  was  bad — the 
sick  list  comprising  one-seventh  of  the  command.  The  prevailing  diseases  were  the 
malarial  fevers  and  acute  diarrhoea. 

The  first  part  of  the  treatment  of  these  cases,  consisted  in  their  removal  to  a  more 
cleanly  and  healthful  locality  ;  cleanliness  of  person  and  clothing  was  enjoined  also, 
General  directions  were  given  as  regards  diet,  and  of  maintaining  their  bowels  in  proper 
condition.  The  second  part  of  the  treatment  was  the  local  application  of  astringents  in 
the  milder  cases,  and  eschoratics,  varying  from  the  mildest  kind  to  that  of  the  most 
potential,  in  conjunction  with  the  astringent  lotions  in  the  severe  ones.  Under  this  re¬ 
gimen,  some  few  improved  ;  none,  however,  recovered;  by  far  the  greater  number  grew 
worse.  Abcesses  now  began  to  form  in  the  axillary  glands  ;  pain  in  the  limbs  and  joints 
increased  in  severity ;  there  was  a  sensation  of  dryness  in  the  throats  of  many,  which 
was  speedily  lollowed  by  ulceration.  Our  apprehensions  were  now  fully  awakened  ; 
each  day  we  inquired  more  and  more  diligently  lor  some  new  symptom  which  might  be 
diagnostic.  Coppery-colored  spots  now  appeared  upon  two  ;  the  hair  began  to  fall  off 
in  a  third,  audit  was  nota  week  before  a  syphilitic  bubo,  in  its  incipient  stage,  appeared 
in  another.  Heretofore,  these  cases  had  been  denominated  “spurious  vaccination.” 
Spurious  they  were  in  one  sense ;  but  specific  in  another,  in  the  strictest  acceptation  of 
the  term. 

It  is  hardly  requisite  for  me  to  state,  that  these  cases  were  placed  upon  a  syphilitic 
treatment,  and  we  had  the  satisfaction,  in  a  comparatively  short  time,  of  seeing  a  great 
number  of  them  returned  to  duty.  A  few  were  sent  to  ‘the  General  Hospital,  one  of 
whom  died. 

In  conclusion,  let  me  remark,  that  having  mentioned  to  Dr.  Frank  Ramsey,  then  Medi¬ 
cal  Director  of  the  Department,  the  nature  of  these  cases,  he  requested  me  to  make  a  re¬ 
port  in  detail  concerning  them,  which  was  done,  and  in  all  probability  found  its  way  to 
the  late  Surgeon  General’s  office. 

Upon  inquiry,  it  was  definitely  ascertained  that  the  virus  for  inoculating  these  patients 
was  obtained  from  a  sailor,  on  the  coast  of  Florida,  who  labored  under  primary  syphilis 
at  the  time  of  vaccination. — Richmond  Journal  of  Medicine  and  Surgery,  June,  1866, 

The  following  article  by  Dr.  Frank  A.  Ramsey,  of  Memphis,  Tenn.,  con¬ 
tains  an  argument  for  the  possibility  of  the  transmission  oi  syphilis  by 
vaccination,  although  its  author  does  not  feel  justified  in  supporting  this 
opinion  in  u  a  strictly  professional  disquisition.”  In  a  letter  from  Dr.  Ram¬ 
sey  to  myself,  accompanying  this  paper,  dated  Memphis,  November  15, 
1866,  he  says:  u The  subject  has  occasioned  me  much  thought,  and  inci¬ 
dentally  some  research,  being  on  the  watch  for  anything,  however  remote, 
at  all  applicable  to  the  question.  But  I  cannot  say  that  I  have  formed  any 
definite  views  regarding  the  question  involved.” 


t Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


341 


ABNORMALITIES  OF  VACCINATION.  BY  FRANK  A.  RAMSEY, 
M.  D.,  MEDICAL  DIRECTOR  OF  THE  (Quondam)  C.  S.  A. 

It  is,  after  conference,  regarded  as  proper  for  the  following  letter  to  be  published.  The 
subject-matter  of  which  it  treats,  was  one  of  exceeding  importance  and  interest,  almost 
from  the  incipiency  of  the  intestine  strife,  in  the  Southern  States,  but  has  not  yet  had, 
in  the  professional  periodicals,  any  exhibition  of  the  attention  it  elicited,  or  any  declara¬ 
tions  of  results  of  observation  or  of  investigation. 

I  do  not  deem  it  necessary  to  defend  now  the  course  of  thought  taken  in  the  letter, 
written  under  the  peculiar  cii’cumstances  connected  with  the  period  at  wfiiich  it  bears 
date.  It  has,  however,  a  reference  to  a  particular  opinion,  which  I  would  not,  at  any 
time,  or  under  any  circumstamces,  support  in  a  strictly  professional  disquisition  ;  that 
opinion  had  been  hastily  expressed  in  the  midst  of  official  business,  and  for  the  purpose 
of  producing  a  particular  effect,  which  I  honestly  judged  to  be  proper  and  best  in  the 
exigency. 

Effects,  very  nearly  resembling  rupia,  followed  vaccination,  with  presumptively  pur6 
virus,  iu  so  many  instances,  as  induced  the  Surgeon  General  to  appoint  medical  officer8 
connected  wffth  the  Southern  army  to  the  duty  of  tracing,  if  any,  the  connection  between 
syphilis  and  vaccinia;  and  the  prosecution  of  this  duty  gave  occasion  to  the  letter,  now 
presented  in  the  hope  that  it  will  lead  others  to  record  their  observations,  experiences 
and  reflections  on  the  same  subject  ;  aud  with  the  intention  on  the  part  of  the  writer 
himself,  under  other  aud  more  favorable  conditions,  to  give  the  subject  further  consid¬ 
eration  : 

MEDICAL  DIRECTOR’S  OFFICE,  > 
Abingdon,  Virginia,  March  20,  1864.  $ 

Doctor  : — Your  note,  of  March  the  eleventh,  informing  me,  that  you  had  been  ap¬ 
pointed  "chairman  of  a  committee  on  the  relation  of  vaccination  to  syphilis,”  and 
making  references  to  my  "report  of  last  year,”  and  asking  me  for  "any  further  informa¬ 
tion  relative  to  spurious  vaccination,”  has  been  received  ;  aud  I  take  the  first  oppor¬ 
tunity,  offered  in  the  performance  of  official  duties,  to  reply. 

I  have  no  facts,  which  have  occurred  within  the  field  of  my  observation,  directly  re¬ 
lating  to  the  sunject,  as  stated  by  you  ;  but,  with  your  permission,  will  coutinue  writing, 
until  I  have  given  you  something  of  the  operation  of  my  mind,  occasioned  by  your  note. 

I  thank  you  for  the  honor  you  have  done  me,  in  preferring  the  request,  and  iu  the  re¬ 
ference  you  have  made  to,  I  presume,  a  letter  written  by  me,  to  a  surgeon  at  Chattanooga, 
a  copy  of  which  I  deemed  proper  to  forward  to  the  Surgeon  General.  That  letter  was 
written,  as  I  now  write  to  you,  currente  calamo,  aud  though  I  preserved  a  copy,  it  was 
left  at  Knoxville,  and  has  doubtless  fallen  into  the  possession  of  the  enemy.  I  am, 
therefore,  prevented  from  making  reference  to  it,  as  I  am  debarred  from  any  ability  to 
consult  authority,  or  to  refresh  my  memory,  as  I  should,  aud  would  do,  if  differently 
situated.  But,  if  I  correctly  remember,  the  latter  was  not  of  such  a  character  as  to 
convey  an  idea,  that  the  observations  were  of  cases  of  spurious  vaccination  Indeed, 
the  basis  of  the  letter  was  furnished  by  observations  of  results,  or  effects  following  the 
introduction,  or  inoculation  of  vaccine  virus  undoubtedly  pure.  And  though  the  result 
or  exhibits  were  in  their  course,  certainly  not  such  as  ordinarily  present  from  vaccina¬ 
tion,  or  as  are  usually  recoguized  as  essentially  cow-pox  ;  yet  observations  were  not  suffi¬ 
ciently  numerous,  or  continued  for  a  time  long  enough,  to  determine  whether  any,  or  the 
same  degree  of  immunity  fiom  small-pox  was  occasioned  in  subjects  thus  affected,  as  in 
those  who  presented  the  ordiuary  course  of  the  cow-pox  disease. 

There  were,  however,  practitioners  of  medicine  who  were  esteemed,  in  communities  in 
which  they  labored,  as  capable  observers,  who  affirmed  that  these  subjects  were  as  free 
from  liability  to  small-pox  as  those  in  whose  economies  the  vaccine  disease  had  exhibited 
nothing  unusual  in  deviation  from  its  regular  course.  If,  then,  the  scab  was  undoubt¬ 
edly  a  pure  vaccine  scab,  and  the  effect  was  perfect,  or  relatively  perfect,  immunity  from 
small-pox,  notwithstanding  there  was  nothing  observed  from  the  application  of  the 
virus,  until  the  production  of  the  ultimate  effect,  at  all  like  vaccine  disease  in  progress, 
the  disease,  I  think,  cannot  properly  be  termed  spurious.  To  be  spurious,  the  vaccine 
virus  must  not  be  in  the  scab,  or  the  effect  must  be  an  absence  of  any  protective  energy 
having  been  impressed  on  the  economy  into  which  the  scab  had  been  introduced.  Vario¬ 
loid  consists  of  exhibits  in  course,  differing  from  variola  in  course;  yet  no  one,  I  pre¬ 
sume,  wrould  feel  himself  justified  in  terming  it  spurious  small-pox,  because  it  is  known 
to  proceed  from  small-pox  virus,  will  communicate  small-pox,  aud  leaves  the  economy  it 
has  effected  impressed  with  irnmuuity  from  a  future  attack  of  small-pox.  Varioloid  is, 
then,  not  spurious  small-pox,  but  small-pox  modified  in  its  exhibits  in  progress  through 
an  economy  previously  impressed  by  the  operation  of  the  virus  of  cowr-pox.  Here  the 
modifying  oause  is  known, 


342 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


So  by  analogy,  the  cases  which  gave  occasion  to  my  letter  of  last  year  were,  each,  an 
instance  of  modified  cow-pox.  The  matter  was  obtained  from  Nashville,  Tennessee,  from 
Atlanta,  Georgia,  and  from  Richmond,  Virginia,  from  surgeons  of  reliability,  and  the 
same  results  were  observed  to  follow  upon  the  introduction  of  the  several  matters,  in 
some  instances  regular  vaccinia,  in  others  abnormal  exhibitions;  indeed,  in  many  an  ap¬ 
proximation  to  the  regular  exhibition  of  the  original  poison  from  cow  matter  could  not 
be  discovered.  And  professional  men,  who  were  not  destitute  of  reputation  for  capacity, 
affirmed,  on  the  strength  of  observations  sufficient  to  satisfy  them,  that  the  economies 
thus  effected  were  impressed  with  immunity  from  small-pox  as  though  they  had  passed 
through  cow-pox  in  its  regular  exhibitions. 

True,  to  make  complete  the  analogy  I  have  instituted,  it  remains  to  establish  by  experi¬ 
ment,  that  true  vaccine  in  its  regular  exhibitions,  in  one  instance,  or  more,  can  be  pro¬ 
duced  by  the  inoculation  of  matter  from  one  of  these  economies.  Which  experiment, 
however,  I  will  leave  to  some  one  with  more  curiosity  and  temerity  than  I  have,  feeling 
satisfied  myself,  that  they  were  modified  cow-pox.  But  in  these  instances,  the  modify¬ 
ing  cause  is  unknown.  It  must,  however,  have  obtained  an  union  with  cow-pox  matter, 
in  its  passage  through  an  economy  peculiarly  affected,  and,  therefore,  resided  in  the  scab, 
not  altered  from  its  ordinary  physical  appearance,  because,  as  yet,  not  sufficiently  imbued 
with  the  acquired  and  modifying  contagion.  Or,  it  must  have  been  a  peculiar  condition 
of  the  individual  economies,  into  which  the  vaccine  virus  was  introduced.  Or,  it  must 
have  been  telluric  or  celestial  relationships  sustained  by  the  particular  persons  affected  ; 
or,  as  Sydenham’s  comprehensive  term  is  applicable  in  giving  expression  to  such  relation¬ 
ships —  “  the  epidemic  constitution.” 

In  my  previous  letter,  I  believe,  I  advanced  this  last  as  sufficient  to  account  for  the 
abnormalities  which  have  been  observed.  It  is  the  more  easily  assumed,  and  probably 
the  more  easily  sustained  position.  I  will,  however,  not  undertake  to  defend  it  here,  for, 
notwithstanding  my  great  respect  to  the  “epidemic  constitution,”  when  I  am  at  the 
bedside  of  a  patient,  I  can,  when  I  am  reflecting,  readily  comprehend,  that  either  one  or 
all  the  positions  may  be  defended,  as  the  source  of  cause  in  its  influence  modifying  cow- 
pox. 

Will  vaccine  virus  become  possessed  of  capacity  acquired  in  its  passage  through  an  econ¬ 
omy  peculiarly  diseased,  to  propagate  such  disease  in  other  economies  ?  The  question 
thus  stated,  will  in  some  degree,  embrace  the  relation  of  vaccinnation  to  syphilis. 

Whether  there  is  truth  in  the  doctrine  which  has  been  promulgated,  that  two  distinct 
contagious  diseases  cannot  exist  at  the  same  time,  in  the  same  economy,  it  is  not  amiss 
to  make  reference  to  it  here  ;  for  if  it  is  not  true,  the  fact  does  not  justify  the  assumption 
that  two  poisonous  causes  cannot  be  introduced  into  an  economy  at  the  same  moment, 
one  having  the  office  of  vehicle  for  the  other — does  not  justify  an  assumption  that  two 
poisonous  causes  in  the  same  economy,  at  the  same  time,  can  occasion  no  modification, 
each  of  the  other,  or  the  one  of  the  other — and  if  it  is  true,  the  fact  or  modification  is  at 
once  established.  More  directly  assertive  of  the  virus  acquiring  a  modifying  capacity, 
even  to  the  complete  destruction  of  original  physical  appearances,  and  exhibitions  of 
effects,  is  the  idea  suggested  during  the  year  1800,  by  Richard  Dunning,  Surgeon,  Plymouth 
Dock,  that  “the  vaccine  disease,  united  with  some  other  virus,  may  have  afforded  the 
more  active  affection  of  variola.”  Dunning’s  reviewer,  from  whom  I  received  my  infor¬ 
mation,  says  “  the  hint  deserves  some  attention,  as  a  point  of  speculation,  which  cannot 
be  subjected  to  the  test  of  experiment.” 

I  only  make  reference  to  it  as  an  assertion  made  long  ago,  that  one  virus  may  be  mod¬ 
ified  by  another  :  for  I  do  not  regard  the  poisons  of  variola  and  vaccinia  as  being  at  all 
identical.  This,  I  think,  is  evident,  if  there  is  truth  in  the  following  statement:  Small¬ 
pox  and  varioloid  will  produce  small-pox,  but  never  cow-pox.  Cow-pox  will  produce 
cow-pox,  but  never  small-pox  or  varioloid.  Cow-pox  will  prevent  the  occurrence  of 
small-pox,  or  mitigate  its  severity,  and  lessen  its  mortality  in  the  human  economy. 
Small-pox  having  occurred  iu  the  human  economy,  is  not  preventive  of  cow-pox,  if  its 
poison  be  introduced  by  inoculation.  Cow-pox,  reproduced  in  the  human  system,  in¬ 
serted  into  the  teat  of  the  cow,  will  produce  cow-pox.  Small-pox,  similarly  introduced 
into  brute  animals,  will  not  produce  small-pox.  This  last  assertion  is  made  by  Wm. 
Woodville,  M.  D.,  London,  1800,  and  by  others,  perhaps  before,  and  several  times  re¬ 
peated  since  ;  and  within  the  past  two  years  medical  officers  in  the  service  have  attempt- 
.  ed,  at  Greenville,  Tenn.,  to  occasion  small-pox  in  a  cow,  in  one  instance.,  and  in  a  calf  in 
another  instance,  using  matter  taken  from  a  case  of  confluent  small  pox  then  under  treat¬ 
ment,  and  inserting  it  under  the  cuticle,  and  introducing  it  into  the  stomachs,  mixed 
with  food,  and  without  any  bad  effects  whatever,  or  any  disturbance  of  the  health  of  the 
animals.  Iam  aware  that  observations  have  been  published,  seeing  ly  different  from 
this,  but  there  is  a  want  of  explicitness  in  connection  with  their  relation  which  justifies 
a  doubt  of  authenticity.  But  this,  if  you  please,  by  way  of  parenthesis. 

The  most  insidious  of  contagious  poisons  affecting  the  human  economy  is,  probably,  the 
syphilitic.  It  has,  doubtless,  occurred  to  almost  every  practitioner  to  observe  cases  in 
which  the  subjects  were  known  to  have  been  treated  for  syphilis,  and  afterwards  to  have 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


343 


exhibited  for  many,  very  many  years,  entire  health,  when  occasion,  known  or  unknown, 
presented,  and  they  offered  themselves  for  treatment,  affected  with  disease  which  the 
physician  pronounced  to  be  syphilitic,  and  which  could  not  be  cured,  except  by  the  ad¬ 
ministration  of  anti-syphilitic  agents.  The  poison  had  remained  latent  or  dormant  for 
these  many  years,  only  awaiting  circumstances  or  conditions  favorable  to  the  exercise 
of  its  capacity  to  effect.  I  had  under  my  charge,  for  twenty  years,  a  family,  the  children 
of  which  were  generally  healthy,  whose  father  was  treated  for  syphilis  from  the  age  of 
nineteen  to  twenty-four,  since  which  he  has  enjoyed  good  health,  seemingly,  in  every 
particular.  His  children,  however,  were  frequently  attacked  with  illness  deemed  suffic¬ 
ient  to  require  my  professional  attention.  No  odds  how  simple  the  attack,  even  though 
when  I  first  called,  the  evidences  were  nothing  more  than  those  of  slight  catarrh,  I  have 
never  known  them  yield  or  mitigate  until  one  dose,  or  more,  of  a  mercurial— generally 
calomel — had  been  administered.  This  I  have  ascribed  to  the  presence  in  their  economies 
of  the  syphilitic  poison  derived  from  their  father,  and  exerting  an  influence  retarding 
healthy  developments,  or  preventing  the  disappearance  of  symptoms  of  diseased  action 
not  in  themselves  syphilitic.  The  cases  cited  in  “  Montgomery  on  Pregnancy”  bear  well 
on  this  point.  A  woman  married  a  man  with  latent  constitutional  syphilis.  She  became 
infected,  which  was  first  exhibited  at  conception,  or  in  miscarriage,  followed  by  secondary 
symptoms  of  syphilis.  A  woman  contracted  syphilis,  was  treated  and  recovered.  A  con¬ 
siderable  time  afterward  she  married.  One,  two,  or  three  children  were  born,  all  affected 
with  syphilis.  The  husband  died,  and  the  woman  married  again,  a  healthy  man  ;  and 
to  this  husband  children  were  born,  and  all  died,  except  one,  affected  with  syphilis  ;  the 
exception  had  mercury  and  recovered.  One  of  the  children  communicated  syphilis  to 
the  woman  by  whom  it  was  nursed. 

But  the  insidiousness  of  this  contagion  is  more  strongly  exhibited  in  another  case,  cited 
by  Montgomery.  A  woman,  whose  husband  had  constitutional  syphilis,  gave  birth  to  a 
child;  which  died  with  syphilis  in  two  months,  the  mother  remaining  wholly  free  from 
any  exhibits  of  the  affection.  This  husband  died,  and  she  married  again,  a  healthy  man. 
Four  years  after  the  former  birth,  she  was  delivered  of  a  child,  which,  in  a  few  months, 
presented  the  same  syphilitic  appearance  manifested  by  the  child  of  the  first  husband. 

If  these  instances  are,  as  observers  affirm  them  to  be,  true,  how  little  effort  does  it  re¬ 
quire  for  the  mind  to  conceive  the  probability  of  a  vaccine  scab,  having  acquired  the 
capacity  from  an  economy,  affected  with  syphilis,  to  propagate  that  disease  ?  If  a  woman 
can  remain  in  health,  after  sexual  congress  with  a  man  affected  with  latent  constitutional 
syphilis,  and  yet,  years  af  terward,  give  birth  to  syphilitic  children,  begotten  by  a  healthy 
man,  it  is  within  the  bounds  of  legitimate  assumption,  to  affirm  that  syphilitic  exhibits 
may  be  manifested  in  au  economy,  by  the  introduction  of  vaccine  matter,  taken  from  an 
economy  tainted  with  syphilis,  even  though  it  is  in  that  system  in  latency,  anu  had 
never  been  developed. 

Two  of  the  cases  which  gave  occasion  to  my  letter  of  last  year,  were  ladies  whose 
husbands  occupied  prominent  and  responsible  positions  in  society.  Neither  the  husbands 
or  wives  were  at  all  under  suspicion  of  immoral  taint.  The  wives  were  vaccinated,  and 
for  many  months  were  aff'eeted  with  ulcerations,  which  under  other  circumstances,  would 
have  been,  without  hesitation,  pronounced  to  he  syphilitic rupia.  They  came  under  the 
care  of  Acting  Assistant  Surgeon  Meadows,  then,  as  now,  in  charge  of  small-pox  hospitals 
in  this  department.  He  put  them  on  the  use  of  bi-chloride  of  mercury,  and  they  both 
recovered  in  ten  or  fifteen  days. 

Permit  me  to  summarize.  Two  contagions  may  he  introduced  into  the  human  economy 
at  the  same  moment  of  time,  and  connected  with  the  same  vehicle  ;  or,  one  contagion 
may  be  the  vehicle  of  another,  and  each  may  exert  its  own  ultimate  effects,  the  interme¬ 
diate  effects  being  the  exhibitions  of  but  one  or  the  other  of  the  contagions  having  made 
impression  ;  or  the  intermediate  effects  may  he  the  exhibitions  of  one  poison,  which,  hav¬ 
ing  passed  their  course,  the  intermediate  effects  exhibiting  the  presence  of  the  other  poi¬ 
son,  supervene  and  pass  their  course.  Syphilis  and  vaccine.  Two  contagions  may 
respectively  modify  each  other.  An  illustration  does  not  occur  to  me.  One  contagion 
may  modify  another,  and  while  it  is  itself  not  subjected  to  a  modifying  influence,  exerted 
by  the  one  it  has  modified,  it  may  be  modified  by  another  contagion.  Cow-pox  and 
small-pox,  cow-pox  and  syphilis.  The  introduction  of  one  contagion  into  an  economy 
may  arouse  another  which  has  remained  dormant,  or  latent,  and  unsuspected.  Cow-pox 
and  syphilis. 

An  item  relative  to  the  treatment  of  small-pox:  Acting  Assistant  Surgeon  Meadows, 
in  two  cases  of  small-pox  occurring  in  children,  employed  croton  oil,  applying  it  on  the 
third  and  fourth  day  of  the  active  fever  to  the  breast,  producing  full  and  confluent  pus- 
tulation.  The  immediate  effect  was  certainly  unpleasant — very  considerable  cerebral 
disturbance,  evidently,  in  its  intensity,  ascribable  to  the  croton  oil  pustulation  ;  but  he 
is  convinced  that  the  course  of  the  disease  was  shortened  two-thirds,  desquamation  be¬ 
ginning  on  the  seventh  day  instead  of  during  the  second  week,  and  that  the  eruption 
was  one-half  less  than  it  would  have  been  under  other  circumstances.  He  has  also  prac- 


344 


Spurious  Vaccination :  Joseph  Jones ,  M.  I). 


ticed  opening  each  pimple  just  as  it  assumed  the  vesicular  character,  with  the  effect,  he 
believes,  of  expediting  the  process,  desquamation  occurring  one-third  the  time  sooner 
than  usual. 

I  have  written,  Doctor,  hurriedly,  hut  I  hope  that  I  have  not  been  so  rapid  as  to  have 
failed  wholly  of  interesting  you,  at  least  for  the  moment. 

Very  respectfully,  your  obedient  servant,  FRANK  A.  RAMSEY, 

Surgeon  and  Medical  Director,  P.  A.  C.  S. 

To  James  Bolton,  M.  D,,  Chairman  Committee  on  the  Relation  of  Vaccina  to  Syphilis, 
Richmond,  Va.  (The  Medical  and  Surgical  Monthly,  May,  1866,  p.  140-147.) 

Dr.  Crawford,  of  Greenville,  Tenn.,  was  able  to  trace  the  impure  virus 
which  produced  indurated  ulcers  and  constitutional  symptoms,  to  a  single 
individual,  and  the  disease  thus  disseminated  by  inoculation,  yielded  to  the 
remedies  best  adapted  to  the  treatment  of  syphilis : 

Greenville,  Tenn.,  January  27,  1867. 

Professor  Joseph  Jones,  M.  D.  : 

Dear  Sir — Having  seen  in  the  January  Number  of  the  Nashville  Journal  of  Medicine  and 
Surgery ,  a  circular  letter  addressed  by  you  to  the  surgeons  of  the  late  Confederate  Army, 
instituting  inquiries  upon  “Spurious  Vaccination, ”  I  desire  to  respond  to  your  inquiries, 
and  to  communicate  those  facts  in  my  possession  which  may  throw  light  upon  this  sub¬ 
ject,  which  is  fraught  with  so  much  interest  to  humanity  and  science. 

During  the  winter  of  1862  and  1863,  I  was  “  Surgeon  in  Charge  ”  of  the  “  Madison  Hos¬ 
pital’’  (Confederate)  at  this  place,  during  which  time  over  1000  patients  came  under  my 
charge.  Small-pox  made  its  appearance  in  the  hospital  fifteenth  November,  1862.  In 
anticipation  of  the  appearance  of  the  disease,  I  had  some  time  previous  procured  a  fresh 
supply  of  genuine  vaccine  virus  by  vaccinating  some  healthy  children.  In  this  way  I 
had  kept  a  fresh  supply  on  hand  since  1856 — that  is,  by  vaccinating  some  healthy  child 
every  few  months.  I  immediately  ordered  all  patients  then  in  hospital  (350)  to  be  vac¬ 
cinated — both  those  that  had  been,  as  well  as  those  that  had  not  previously  been  vac¬ 
cinated-  The  matter  took  well  upon  all  who  had  not  been  vaccinated,  and  imperfectly 
in  some  cases  that  had  been  vaccinated.  A  “  pest-house  ”  was  established,  and  the 
infected,  as  soon  as  the  nature  of  the  disease  was  manifested,  removed  at  once  to  it.  The 
disease  did  not  extend  to  the  patients  in  hospital ;  but  from  time  to  time  patients  were 
admitted,  many  of  whom  proved  to  be  suffering  with  variola.  But  in  no  single  instance 
was  the  disease  communicated  to  those  that  had  been  recently  vaccinated  or  re-vacci¬ 
nated,  and  but  six  cases  of  varioloid  occurred  out  of  the  350  patients,  all  of  whom  had 
been  exposed  to  the  contagion  of  small-pox. 

There  wras  great  alarm,  both  among  citizens  and  soldiers ;  for  the  small-pox  cases  were 
exceedingly  fatal,  owing  to  the  want  of  proper  comforts  and  attention.  Out  of  ninety 
cases,  forty  proved  fatal.  Neither  the  citizen  nor  soldier  was  satisfied  of  his  immunity 
from  danger,  unless  he  could  make  a  “sore”  of  some  sort  upon  his  arm.  Consequently 
vaccination  was  perseveringly  sought  from  the  ugliest  and  foulest  looking  ulcers.  The 
idea  being  with  the  masses,  that  vaccination  loses  its  effects  after  a  few  years,  and  must 
be  renewed  ;  if  a  sore  was  not  produced  by  matter  from  one  arm,  another  was  sought. 
This  state  of  things  continued  without  any  mischievous  effects  until  about  the  first  of 
January,  1863,  when  Col.  Clayton,  then  Commander  of  the  Post  at  this  place,  who  had 
been  on  leave  of  absence  some  weeks  in  North  Carolina,  returned  with  an  ugly  looking 
ulcer  upon  his  right  arm  which  was  reported  to  be  genuine  matter.  The  cry  of  eureka 
was  raised,  and  it  was  not  long  until  dozens,  both  citizens  and  soldiers  had  this  matter 
inserted  into  their  arms.  From  this  dates  the  history  of  “  Spurious  Vaccination.”  Col. 
Clayton  had  been  successfully  vaccinated  some  years  before;  but  so  soon  as  it  was  known 
that  we  were  in  the  midst  of  the  most  loathsome  of  all  diseases,  I  re-vaccinated  him  twice 
with  genuine  virus,  but  without  effect.  What  the  history  of  the  case  was  from  which  he 
received  the  infectious  matter,  I  never  learned,  for  the  Colonel  could  not  find  out.  Col. 
Clayton  was  about  twenty-one  years  of  age,  sanguine  temperament,  and  in  excellent 
health  at  the  time  he  received  the  infectious  matter  into  his  arm.  The  ulcers  I  regarded 
at  the  time,  and  still  regard,  as  caused  by  inoculation  with  syphilitic  virus.  The  cases 
ran  an  indefinite  course  of  from  three  weeks  to  six  months,  and  yielded  only  to  Blue  Mass, 
Iodide  Potassium,  internally,  and  Sul.  Cupri.  externally.  Some  cases  taken  in  their  incipi- 
ency,  yielded  in  a  few  days  to  the  external  treatment  alone. 

It  is  proper  to  state  that  there  was  no  tendency  to  scorbutic  disease  among  either  sol¬ 
diers  or  citizens,  and  the  infectious  matter  was  equally  as  severe  among  the  citizens  as 
soldiers.  The  hospital  was  well  provided  with  everything  calculated  to  promote  com¬ 
fort  and  health.  The  patients  were  in  good  houses,  had  plenty  of  clothing,  and  rations 
in  abundance,  such  as  fresh  meats,  fruits,  potatoes,  cabbage,  etc.  There  was  no  scarcity 
of  these  things  in  this  country  at  that  time,  and  what  the  Government  did  not  provide 
the  citizens  supplied  with  a  liberal  hand. 


Spurious  Vaccination:  Joseph  Jones,  M.  1). 


345 


This  “  spurious  vaccination  v  yielded  no  protection  whatever  from  variola.  I  have 
seen  more  than  a  dozen  cases  of  variola  occur  where  there  were  large  ulcers  from  this 
spurious  virus,  the  patients  thinking  they  were  protected  from  the  disease  hy  such  sores. 
The  spurious  matter  would  take  effect  in  all  cases  and  all  sorts  of  constitutions. 

About  this  time  orders  were  issued  from  Surgeon  General  Moore  to  procure  fresh  vac¬ 
cine  virus  through  the  cow-  I  tried  the  experiment  three  times  without  succeeding. 
First  on  a  cow  seven  years  old,  with  a  calf  six  months  old.  Then  a  young  heifer  two 
years  old,  and  finally  the  calf.  I  inserted  the  matter  in  the  teats,  nose,  ears  and  various 
parts  of  the  skin,  but  never  succeeded  in  getting  a  crust.  Finally  I  fed  the  calf  on  the 
dried  scabs  mixed  with  its  food,  but  it  died  without  yielding  me  the  much  sought  for 
treasure. 

In  August,  1863,  the  Confederate  Army  evacuated  East  Tennessee,  and  in  September, 
1863,  the  Federal  Army  took  possession  and  held  for  a  time.  That  army,  under  Gen. 
Burnside,  was  composed  of  new  recruits,  made  up  mostly  of  six  months  volunteers,  many 
of  whom  had  not  been  in  the  service  three  months.  This  same  disease  was  among  them. 
This  army  was  abundantly  supplied  with  anti-scorbutics,  and  fed  with  a  liberal  hand, 
and  had  never  been  exposed  to  hardships. 

My  best  wishes  for  your  success  in  your  undertaking. 

Yours  sincerely,  S.  P.  CRAWFORD. 

If  such  accidents  had  been  confined  entirely  to  the  Confederate  Army,  or 
to  the  period  of  the  war,  when  the  citizens  were  to  a  greater  or  less  extent 
subjected  to  unusual  privations,  and  to  the  action  of  the  most  depressing 
causes,  the  views  of  those  who  denied  emphatically  the  possibility  of  trans¬ 
mitting  the  poison  of  constitutional  syphilis  by  the  process  of  vaccination, 
would  receive  at  least  a  show  of  support  from  the  apparent  dependence  of 
the  abnormal  phenomena  accompanying  the  vaccine  disease,  upon  the  de¬ 
pressed  and  deranged  states  of  the  system,  induced  by  improper  nutrition 
and  physical  causes. 

It  happened,  however,  that  a  large  number  of  cases,  which  were  referred 
by  both  citizens  and  physicians  to  the  contamination  of  the  vaccine  virus 
with  the  syphilitic  poison,  occurred  in  the  quiet  manufacturing  community 
of  Graniteville,  after  the  close  of  the  war. 

Under  the  kind,  liberal  and  efficient  management  of  the  intelligent  head 
ot  the  Graniteville  Manufacturing  Company,  the  operatives  enjoyed  com¬ 
fortable  dwellings  and  abundant  supplies  of  nutritious  and  wholesome  food. 
This  class  of  the  population  of  South  Carolina  were,  perhaps,  more  favora¬ 
bly  situated  as  to  subsistence  and  support,  than  the  great  majority  of  the 
citizens  of  South  Carolina,  whose  dwellings  and  barns  had  been  laid  in 
ashes,  and  whose  social  and  agricultural  system,  the  growth  of  centuries, 
had  been  so  completely  overturned  as  to  convert,  without  warning,  the 
richest  into  the  poorest. 

The  following  report  of  Dr.  W.  F.  Percival,  of  Aiken,  South  Carolina,  is 
important,  as  being  the  most  clear  and  intelligent  statement  which  I  was 
able  to  obtain,  after  considerable  inquiry: 


REPORT  ON  THE  COMMUNICATION  OF  SYPHILIS  THROUGH 
THE  MEDIUM  OF  VACCINE  VIRUS  AMONGST  THE  INHABI¬ 
TANTS  OF  GRANITEVILLE  AND  VICINITY,  1806.  BY  W.  F. 
PERCIVAL,  M.  D.,  OF  AIKEN,  S,  C. 

Aiken,  November  15,  1866. 

Profeasor  Joseph  Jones,  M.  D.: 

Bear  Sir — I  received  your  letter  yesterday,  and  inclose  a  copy  of  my  report  on  spurious 
vaccination  with  pleasure.  I  intended  sending  it  to  one  of  the  medical  journals,  but 
have  uever  had  time  to  revise  and  prepare  it  for  publication  ;  the  facts ,  however,  are  all 

I  am,  with  high  esteem,  yours  very  respectfully,  W.  F.  PERCIVAL. 

Spurious  Vaccination  — The  Epidemical  Society  of  London  prepared  four  questions  on 
the  subject  of  vaccination,  to  be  addressed  to  the  most  eminent  medical  men  in  Europe. 
The  third  was  as  follows  : 


346 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


Have  you  any  reason  to  believe,  or  suspect,  that  lymph  from  a  true  Jennerian  vesicle 
has  ever  been  a  vehicle  for  syphilitic  or  other  constitutional  infection?  Among  the 
number  who  responded  (over  400),  but  three  asserted  their  belief,  twenty-seven  in  doubt 
and  nine  had  no  experience.  The  rest  asserted  that  it  could  not  be  done. 

In  a  report  from  the  College  of  Faculty  of  Medicine,  at  Prague,  the  following  language 
is  used  :  “The  possibility  of  inoculation  with  syphilis  by  means  of  vaccination,  (al¬ 
though  not  a  single  completely  attested  fact  is  known  in  this  country,)  is  not  to  be 
excluded,  for  the  conveyance  of  syphilis,  by  means  of  inoculation,  has  been  placed  beyond 
a  doubt.” 

In  the  face  of  so  much  testimony  against  the  possibility  of  sucli  an  occurrence,  the  fol¬ 
lowing  report  will  perhaps  throw  some  light  on  the  subject. 

About  the  last  of  April,  1866,  1  was  requested  to  take  charge  of  some  cases  of  spurious 
vaccination,  at  the  manufacturing  village  of  Graniteville,  One  hundred  and  fifty  cases 
were  presented  for  examination,  men,  women,  and  children,  of  all  ages,  from  fifty  years 
to  twelve  months.  The  larger  proportion  were  operatives  in  the  factory,  the  others  en¬ 
gaged  in  out-door  work.  There  was  every  variety  of  constitution,  from  the  pale  attenu¬ 
ated  girl,  to  the  hardy  and  robust  laborer.  Of  the  one  hundred  and  fifty  cases,  ninety- 
three  had  been  previously  vaccinated.  The  appearance  of  the  sore  was  identical  in  every 
ca&e,  viz ;  an  excavated  ulcer,  of  circular  form,  with  raised  and  hardened  edges  and  base. 
They  varied  in  size,  from  one  half  to  two  inches  in  diameter,  covered  with  grey  or  dark 
sloughy  matter,  and  secreting  unhealthy  pus.  There  was  no  appearance  of  granulation. 
In  some  cases  ulcers  of  a  similar  character,  appeared  on  the  arms  affected;  others  on  the 
opposite  arm,  and  in  a  few  on  the  lower  limbs.  In  some,  abscesses  formed  on  the  inside 
of  the  arm,  and  m  nearly  all  the  axillary  gl&nds  were  inflamed,  and  many  suppurated. 
A  thick  and  unhealthy  crust  would  form,  to  be  soon  separated  by  the  pus  which  accumu¬ 
lated  beneath.  In  one  case,  there  was  a  copper-colored  eruption  on  the  body  and  limbs ; 
in  two  or  three  the  hair  dropped  off.  None  of  these  cases  were  in  the  primary  stage. 
The  disease  had  existed  from  three  to  eight  weeks.  Most  of  them  pursued  their  ordinary 
avocations,  as  far  as  possible,  and  complained  of  no  constitutional  symptoms,  or  auy  loss 
of  appetite. 

The  history  of  these  cases,  as  given  to  me  by  the  individuals  first  vaccinated,  was,  that 
they  had  obtained  the  virus  from  a  man  whom  they  afterward  discovered  to  have  had 
primary  syphilis.  One  was  vaccinated  from  another,  and  so  it  spread.  None  of  the  ulcers 
had  evidenced  any  tendency  to  heal.  One  of  the  worst  cases  was  a  man  wrho,  two  years 
previously,  had  small-pox. 

The  usual  treatment,  both  constitutional  and  local,  for  venereal  ulcers,  effected  a  cure 
in  from  three  to  six  weeks. 

It  might  be  supposed  that  the  predisposing  cause  of  the  ulcers  existed  in  a  vitiated 
condition  of  the  blood,  dependent  on  local  causes,  but  I  had  twelve  or  fifteen  cases  in 
other  localities,  some  of  them  ten  miles  distant.  All  of  these  had  obtained  the  virus  with 
which  they  were  vaccinated  at  Graniteville.  All  of  these  were  strong  and  healthy  indi¬ 
viduals.  Again,  most  of  the  cases  reported  had  been  vaccinated  a  short  time  previously, 
and  had  progressed  in  the  usual  manner  without  any  trouble,  showing  that  no  local  cause 
liad  produced  any  derangement  of  their  system. 

As  I  did  not  see  the  individual  from  whom  the  virus  was  first  obtained,  I  am  unable  to 
say  that  he  really  had  primary  syphilis. 

I  cannot,  therefore,  draw  positive  conclusions  from  the  above  cases,  and  only  present 
the  report  as  information. 

On  the  other  hand,  many  of  the  Confederate  surgeons  entertained  views 
similar  to  those  announced  by  Dr.  Habersham,  and  denied  that  any  of  the 
cases  of  spurious  vaccination  were  syphilitic  in  their  origin  or  relations. 

Thus,  Dr.  S.  F.  Stout,  of  Pulaski,  Tenn.,  formerly  Medical  Director  of 
the  general  hospitals  attached  to  the  Army  of  Tennessee,  in  his  reply  (dated 
near  Pulaski,  November  19,  1866)  to  my  inquiries,  says : 

I  am  not  satisfied  that  there  occurred  a  well-authenticated  instance  of  the  propagation 
of  secondary  syphilis  by  means  of  the  so-called  spurious  vaccine  matter.  I  think  that 
the  injurious  effects  were  chiefly  produced  upon  persons  already  diseased  syphilitic,  scor¬ 
butic,  or  while  living  in  an  atmosphere  infected  by  the  causes  of  gangrene  and  erysipelas. 
A  vast  majority  of  these  cases  were  those  of  individuals  who  had  been  previously  vac¬ 
cinated,  and  in  very  many  instances  the  virus  used  was  taken  from  the  arms  of  re-vac¬ 
cinated  individuals.  .  Ihus,  common  pus,  and  even  ichor,  was  no  doubt  inoculated,  which 
produced  effects  similar  to  those  that  are  caused  by  a  wound  received  while  dissecting  a 
dead  body,  modified  in  many  instances,  no  doubt,  by  the  conditiou  of  the  patient’s  health 
and  the  morbific  influences  to  which  he  was  exposed. 

Prior  to  my  assumption  of  authority  to  take  steps  to  stop  the  evil,  I  am  satisfied  that 
there  were  several  errors  in  practice  among  our  troops.  First,  the  order  requiring  all 
soldiers  to  be  vaccinated,  whether  they  had  been  previously  effectually  vaccinated  or 


Spurious  Vaccination :  Joseph  Jones,  M.  D. 


347 


not.  This  order  was  literally  interpreted  and  acted  on  by  the  superintendents  of  vacci¬ 
nation  appointed  by  the  Surgeon  General.  Secondly,  many  soldiers,  iguorant  of  the 
characteristics  of  genuine  vaccinia,  vaccinated  themselves,  or  each  other,  without  con¬ 
sulting  a  surgeon.  Thus,  no  doubt,  common  pus,  and  even  ichorous  matter,  were  often 
inserted.  Thirdly,  when  variola  first  appeared  in  our  army,  so  great  was  the  fear  of  the 
disease,  and  the  consequent  anxiety  to  vaccinate  everybody  in  the  army,  or  in  its  vicin¬ 
ity,  that  the  temptation  to  the  surgeon  to  use  any  virus  within  his  reach  was  very  great. 
Thus,  much  matter  was  used  which  ought  to  have  been  rejected  by  surgeons. 

In  my  investigations  I  could  not  learn  of  a  single  well  authenticated  instance  in  which 
due  care  had  been  taken  in  the  selection  of  the  virus,  whether  in  the  form  of  lymph,  or 
of  the  dried  scab,  that  was  accompanied  by  the  evils  of  so-called  spurious  vaccination, 
in  a  perfectly  healthy  individual,  iu  an  atmosphere  uninfected  by  erysipelas  or  gan¬ 
grene.  Believing  these  conclusions  to  be  correct,  when  as  Medical  Director  of  the  hospitals  I 
undertook  to  relieve  the  army  of  the  evil,  I  made  provisions  to  supply  it  with  virus 
taken  only  from  the  arms  of  healthy  children,  who  had  never  before  been  effectually  vac¬ 
cinated.  By  the  zeal  and  energy  of  medical  officers  designated  at  every  hospital  post, 
from  supplies  of  virus  obtained  from  the  Surgeon  General,  S.  P.  Moore,  and  Surgeon  J. 
C.  Mullins,  superintendent  of  vaccination  of  my  department,  appointed  by  me,  the 
army  in  the  field  and  the  hospitals  in  the  rear  were  amply  furnished  with  virus  from 
healthy  children.  No  soldier  was  vaccinated  with  matter  taken  from  another  soldier. 

The  supply  was  so  abundant  that  there  was  not  temptation  to  use  any  other  part  of 
the  dried  crust  than  the  vitreous,  mahogany-colored  portion.  I  recommended  that  no 
soldier  who  had  been  vaccinated  within  a  few  years  past,  and  who  had  the  characteristic 
mark,  should  be  revaccinated,  unless  positively  known  to  have  been  exposed  to  variolous 
contagion  ;  and  especially,  if  he  were  laboring  under  any  form  of  syphilis,  or  was  scorbu¬ 
tic,  or  was  livingjn  an  atmosphere  infected  with  gangrene  or  erysipelas. 

Under  this  practice  the  so-called  spurious  vaccination  disappeared  from  our  army,  and 
before  the  close  of  the  war  it  might  be  said  to  have  ceased  to  exist  in  Georgia. 

Having  thus  far  entered  into  a  statement  of  the  impressions  I  have,  and  of  facts  bear¬ 
ing  upon  the  subject,  it  may  not  be  amiss  to  say  to  you  that  my  observations  and  experi¬ 
ence  during  the  war  lias  confirmed  my  faith  iu  the  prophylactic  powers  of  the  Jennerian 
virus.  I  use  the  term  Jennerian  to  designate  that  vaccine  virus  which  has  been  propa¬ 
gated  from  that  originally  supplied  by  Jenner.  The  immunity  of  so  many  thousands  of 
soldiers  and  officers  witnessed  during  the  war,  and  the  comparatively  small  number  of 
the  vaccinated  who  were  attacked  with  variola  or  varioloid,  enhance  my  estimate  of  the 
protective  power  of  vaccinia,  rather  than  diminishes  it,  as  has  been  the  case  with  many 
whose  field  of  observation  has  been  comparatively  smaller  than  mine. 

The  testimony  of  Dr.  E.  A.  Flewellen  before  the  United  States  Military 
Court,  iu  the  trial  of  Henry  Wirz,  is  of  interest  in  this  connection,  in  so  far 
as  it  relates  to  the  prevalence  and  nature  of  spurious  vaccination  in  the 
Western  Army  of  the  Confederate  States. 


MEDICAL  TESTIMONY— THE  CONDITION  OF  THE  PBISONEES 

IN  THE  HOSPITAL. 


Dr.  E.  A.  Flewellen  for  the  pi-osecution. 
****###*  * 


September  28,  1865. 

#  *  #  * 


VACCINATION. 

Q. — Can  you  tell  us  what  effect  vaccination  had  upon  your  own  soldiers  and  citizens? 

The  Witness — Do  you  mean  spurious  vaccination,  as  it  is  called  ? 

Mr.  Baker — Yes,  sir. 

A.  — The  first  I  ever  heard  or  knew  of  spurious  vaccination — 

The  Judge  Advocate — State  only  what  you  saw  or  knew  at  Andersonville. 

Witness — I  know  nothing  about  the  vaccination  at  Andersonville. 

Q. — Go  on  and  state  all  you  know  about  spurious  vaccination  anywhere  throughout 
the  Southern  Confederacy. 

The  Judge  Advocate  objected  to  the  question,  on  the  ground  that  even  if  it  could  be 
proved  that  persons  throughout  the  South  were  poisoned  by  means  of  vaccination,  it 
would  furnish  no  proof  that  prisoners  of  war  at  Andersonville  were  not  so  poisoned,  and 
could  not  in  any  way  exculpate  any  one  who  was  inculpated  by  the  evidence  already 
brought  before  the  court. 

Mr.  Baker  argued  that  the  question  was  proper.  The  defence  proposed  to  show  that 
the  same  effects  experienced  from  vaccination  at  Andersonville  had  been  experienced 
throughout  the  whole  South  ;  that  the  same  matter  used  at  Andersonville,  was  so  tar  as 
could  be  ascertained,  used  in  various  places  throughout  the  South,  and  had  similar  effects 
on  soldiers  and  private  citizens. 


348 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


If  the  defense  could  show  that  this  vaccine  matter  was  used  upon  Confederate  soldiers, 
aud  produced  the  same  results  as  those  testified  to  in  the  case  of  Federal  prisoners,  it 
would  tend  to  rebut  or  disprove  one  of  the  elements  of  the  alleged  conspiracy. 

The  court,  after  deliberatiou,  sustained  the  objection. 

Witness. — I  know  of  the  effects  of  vaccination  on  the  troops  in  Georgia. 

Q. — State  to  the  court  what  their  effects  were  on  your  troops. 

Objected  to  by  the  Judge  Advocate,  uuless  it  could  be  shown  that  the  vaccine  matter 
used  for  the  Confederate  tx-oops  was  obtained  from  the  same  source  as  that  used  on  the 
Union  prisoners. 

After  deliberation  the  objection  was  overruled. 

A. — While  the  army  of  Gen.  Bragg  was  at  Tullahoma  I  was  medical  director,  and  1 
know  that  very  great  complaint  was  made  to  me  as  to  the  character  of  the  vaccination 
practiced  in  the  army.  A  large  number  of  men  were  represented  as  unfit  for  duty.  I 
think  that  one  division  represented  nearly  a  thousand  men  as  unlit  for  duty  on  account 
of  spurious  vaccination.  I  saw  a  number  of  cases  in  the  early  progress  of  the  vaccina¬ 
tion,  but  they  presented  nothing  abnormal  that  I  could  detect.  But,  as  it  advanced,  the 
cases  seemed  to  have  the  appearance  very  nearly  of  syphilitic  rupia.  It  diffused  itself 
more  or  less  over  the  whole  surface.  A  large  number  of  surgeons  regarded  it  as  a  com¬ 
plication  of  vaccinia  and  syphilis.  Finally  they  settled  into  the  opinion  that  it  was  not 
syphilitic.  Tlnei'e  never  was,  I  may  say,  any  settled  opinion  among  the  surgeons  of  the 
Confederate  Army  as  to  what  was  the  true  character  of  this  impure  virus.  (40th  Con¬ 
gress,  second  session,  House  of  Representatives,  Ex.  Doc.  23  ;  trial  of  Henry  Wirz,  pp. 
472-473.) 


SMALL-POX  EPIDEMIC  IN  MOBILE  DUEIXG  THE  WINTER,  OF 
1865-6.  BY  J.  C.  NOTT,  M.  D.,  OF  MOBILE,  ALABAMA. 

Mobile,  December  12,  1866. 

Joseph  Jones,  M.  D., :  , 

My  Dear  Sir — Your  letter  of  the  fifth  reached  me  yesterday,  and  I  regret  to  have  to 
plead  ignorance  again  on  the  subject  iu  hand.  I  have  had  to  treat  a  good  many  cases  of 
spurious  vaccination,  but  have  uo  clear  facts  as  to  their  origin.  Many  of  them  look  syph¬ 
ilitic — rupial  sores,  etc. — they  are  more  properly  syphiloid.  I  am  not  sure  but  the  ugly 
sores  we  saw  in  the  army  are  as  anomalous  as  many  other  forms  of  disease  which  seemed 
to  result  from  crowded  camps  aud  hospitals,  foul  air,  bad  diet,  etc. 

Dr.  J.  T.  Gilmore,  who  was  a  medical  director  in  the  Virginia  Army,  saw  a  great  deal 
of  this  spurious  vaccine,  and  has  promised  me  to  write  you  about  it.  We  have  in  Mobile 
a  medical  society,  and  it  is  the  duty  of  each  member  in  turn  to  read  a  paper  once  a 
month.  Some  six  or  eight  months  ago,  in  the  performance  of  this  duty,  I  threw  together 
some  rough  and  hasty  notes  on  vaccination,  etc.,  which  I  send  you  in  their  rude  state. 
If  you  can  find  any  useful  idea  or  suggestion,  you  are  at  liberty  to  use  it  as  you  like. 

Very  respectfully  and  truly  yours,  J.  C.  NOTT. 

The  extraordinary  prevalence  of  small-pox  in  Mobile  during  the  winter  just  passed,  presenting  all  the 
characters  of  a  true  epidemic,  deserves  to  he  placed  on  record  as  a  matter  of  history,  and  deserves  much 
fuller  detail  than  I  propose  at  present  to  give  it 

The  reason  for  this  extraordinary  prevalence  of  small-pox  not  only  in  Mobile,  hut  more  or  less  throughout 
the  whole  of  our  Southwn  States,  is  very  obvious.  It  is  now  about  ten  months  since  the  close  of  our  civil 
war,  which  has  thrown  our  population  into  great  confusion  ;  and  the  negroes  having  been  suddenly  liber¬ 
ated,  have  from  various  causes  been  congregated  in  towns,  and  freed  from  their  accustomed  restraint  and 
the  fostering  care  of  former  masters.  A  large  portion  of  them  had  never  been  vaccinated,  scarcely  any 
vaccinated,  and  they  therefore  afforded  an  unprecedented  amount  of  material  for  the  disease.  Fully  nine 
out  of  ten  of  the  deaths  from  small-pox  have  been  among  the  freedmen . 

The  disease  having  been  scattered  by  this  class,  through  all  parts  of  the  city  and  surrounding  country,  the 
whole  atmosphere  became  infected,  and  a  true  epidemic  constitution  established.  A  great  many  of  the  old 
citizens,  both  white  and  black,  have  been  attacked  by  varioloid.  The  cases,  however,  among  the  better 
class,  who  have  be£n  in  the  habit  of  paying  proper  attention  to  revaccination,  have  been  few  and  mild. 

With  regard  to  the  proteection  afforded  by  vaccination,  I  must  say  that  it  is  difficult  to  imagine  a  more 
perfect  triumph  than  that  of  the  immortal  jenner.  My  own  experience  leads  me  to  declare  that  I  have  not 
seen  more  than  three  or  four  cases  of  varioloid  amongst  those  I  have  been  in  the  habit  of  attending  and  re¬ 
vaccinating  ;  but  I  must  add  that  I  have  paid  no  attention  to  age ;  I  have  revaccinated  young  children  as 
indiscriminately  as  the  adults  and  aged,  and  have  seen  no  appreciable  difference  in  their  susceptibilities 
either  to  vaccine  or  to  varioloid. 

It  has  been  evident,  from  the  intense  epidemic  constitution  of  the  atmosphere,  that  we  should,  had  it  not 
been  for  vaccination,  had  at  least  three-fourths  of  our  population  attacked  by  small-pox.  There  have  been 
treated  in  the  pest  house  alone,  up  to  the  present  date,  March  20,  1866,  about  six  hundred  cases.  One  hun¬ 
dred  and  eighty  cases  are  now  under  treatment  in  that  establishment,  and  there  seems  to  be  no  abatement 
in  the  progress  of  the  disease.  I  think  it  would  he  within  the  mark  to  say  that  at  least  three  thousand 
cases  of  small-pox  of  all  grades  had  occurred  in  Mobile  during  the  past  five  months. 

The  panic  produced  has  caused  almost  all  of  our  old  citizens  of  all  ages  to  seek  revaccination,  which  have 
given  some  interesting  results.  Many  adults,  vaccinated  in  early  life  and  exhibiting  good  cicatrices,  have 
received  the  vaccine  in  a  spurious  form,  though  their  systems  had  refused  it  several  times  previously  since 
the  first  vaccination,  thus  showing  that  when  an  epidemic  influence  is  prevailing,  the  vaccine  is  much  more 
apt  to  take  effect  in  some  form.  This  fact  has  been  noticed  by  writers  on  the  subject,  and  has  been  very 
striking  in  the  prevailing  epidemic.  In  not  a  few,  also,  hearing  good  marks  from  childhood,  who  had 


Spurious  Vaccination  :  Joseph  Jones ,  M.  I). 


349 


repeated  revacoinations  in  former  years,  the  vaccine  this  year  has  taken  perfectly  and  run  its  course  regu 
larly  as  m  those  newly  vaccinated.  Such  patients,  doubtless,  were  in  danger  of  taking  genuine  small-pox 

How  long  does  vaccination,  when  done  in  childhood,  protect  against  small-pox?  Does  it  really  wear  out 
in  a  given  time,  or  at  ad?  Were  I  to  judge  by  my  own  experience,  it  never  wears  out,  and  time  has  little 
influence  on  it.  It  the  system  is  one  &  fully  affected,  it  is  good  for  tbe  life-time;  in  order,  however,  to  be 
sure  that  the  system  is  tully  affected,  it  is  proper  to  repeat  the  vaccination  several  times  till  the  system 
fairly  refuses  good  virus. 

It  should  be  remembered  that  when  the  population  of  a  town  is  exposed  to  the  influence  of  small-pox,  or 
any  other  epidemic  disease,  a  considerable  per  centage  of  them  are  not  susceptible  to  the  disease  at  that 
time  and  will  escape  it.  Members  of  the  same  family  wrill  not  communicate  it  to  those  around  ;  even  chil¬ 
dren  sleeping  in  the  same  bed  with  others  sick  of  small-pox  will  not  take  it.  Why  these  immunities  we 
know  not,  but  yet  the  facts  are  indisputable. 

So  with  the  vaccine.  Suppose  you  are  called  upon  to  vaccinate  lialf-a-dozen  children,  and  it  is  performed 
on  them  all  at  the  same  time  and  with  the  same  virus.  What  happens?  One  may  not  receive  it  at  all :  in 
all  the  others  it  may  take,  showing  its  characteristic  vesicle,  but  affecting  the  individuals  in  various  de¬ 
grees,  thus  showing  different  grades  of  susceptibility.  In  one  a  good  vesicle  will  appear  without  constitu¬ 
tional  symptoms,  in  another  the  vesicle  may  be  accompanied  by  high  fever,  glandular  swellings,  etc.,  and 
the  others  will  present  intermediate  grades  of  effect. 

How  the  one  which  did  not  respond  at  all  to  the  vaccine  virus,  if  exposed  to  small  pox,  might  not  at  that 
time  take  the  disease,  on  account  of  a  temporary  insusceptibility,  but  at  some  future  day  under  similar  ex¬ 
posure  might  be  attacked  by  confluent  small-pox.  The  one  which  took  the  vaccine  so  fully  as  to  develop 
severe  local  and  general  symptoms  would  probably  be  protected  for  life,  against  either  vaccine  or  variola. 
The  other  children  which  had  mild  local  symptoms,  and  little  or  no  fever,  if  exposed  to  small-pox  in  after 
life  would  be  attacked  by  varioloid  in  various  degrees,  according  to  the  degree  of  susceptibility  left  m  the 
system.  If  vaccinated  after  one  or  more  years,  the  vaccine  would  again  show  to  a  greater  or  less  extent  its 
characteristic  effects  on  some  of  the  cases,  thus  proving  that  the  system  had  not  been  fully  affected  by  the 
first  vaccination,  and  consequently  not  fully  protected  against  the  poison  of  small-pox. 

,  Now  in  the  case  of  these  six  children,  it  must  be  remembered  that  when  they  were  vaccinated  the  first 
time,  the  morbid  poison  was/orcod  upon  the  system  without  any  regard  to  its  present  susoeptibility.  The 
system  might  be  disposed  to  reject  it  entirely,  or  to  receive  it  in  various  degrees,  just  as  when  exposed  to 
contagious  diseases  in  the  natural  way.  Some  children  during  the  present  epidemic,  could  not  be  brought 
under  the  influence,  and  in  one  ease  of  a  healthv  child  of  three  months  old,  it  did  not  take  until  the  ninth 
trial . 

We  have  no  criterion,  by  which  we  can  tell  before  hand  what  is  to  be  the  effect  of  any  disease  on  individ¬ 
uals.  Suppose  small  pox,  diphtheria,  or  scarlet  fever  appears  in  a  boarding-school,  what  happens?  Some 
escape  entirely,  and  the  others  are  affected  in  all  possible  grades.  Here  you  may  say  that  the  disease  is 
again  forced  upon  the  subjects,  and  they  receive  or  reject  the  poison  in  whole  or  in  part,  according  to  the 
condition  of  each  individual.  There  is  this  great  difference  in  the  two  cases.  In  the  boarding-school  ex¬ 
ample,  the  children  take  the  disease  in  the  natural  way,  and  each  one  may  receive  or  reject  it  as  the  system 
chooses;  but  in  the  case  of  vaccination  the  poison  is  thrust  into  the  blood  of  the  subject  by  the  physician 
without  any  regard  to  the  present  susceptibility,  and  the  system  is  compelled  to  fight  the  enemy  as  it  best 
can.  Under  these  circumstances  it  is  rational  to  conclude,  that  in  the  case  of  vaccination,  the  system  being' 
forced,  resists  the  influence  of  the  virus  to  a  certain  extent  in  many  instances,  and  thus  leaves  the  system 
j,ut  partially  protected,  against  the  poison  of  small-pox. 

Another  important  question  arises  as  to  the  duration  of  the  protecting  influence  of  vaccine.  Does  it 
“ wear  out ”  in  a  given  time,  or  at  anytime  during  our  three-score-and-ten  ?  I  confess  that  I  have  never 
seen  any  facts  to  prove  that  it  does  wear  out,  where  the  system  has  been  one e  fully  affected.  How  many 
hundreds  of  individuals  does  every  physician  see  in  whom  one  vaccination  in  childhood  protects  perfectly 
against  both  small-pox  and  vaccination  through  life?  There  are  ten  thousand  of  such  cases  to  prove  that 
vaccine  does  not  wear  out.  My  own  experience,  which  corresponds  with  that  of  the  other  physicians  of 
Mobile  during  the  present  epidemic,  goes  to  prove  that  in  vaccination  the  virus  just  as  often  takes  effect  in 
children  of  all  ages,  from  one  year  upwards,  as  in  those  vaccinated  half  a  century  previously.  I  have,  dur¬ 
ing  the  past  few  months,  seen  scores  of  children  bearing  good  marks,  from  the  ages  of  one  to  eight  or  ten 
years,  in  whom  the  revaccinations  have  taken,  or  who  have  been  attacked  by  varioloid.  I  have  also  seen 
scores  of  all  ages  who  were  insusceptible  to  both  forms  of  this  virus. 

I  have  seen  no  evidence  whatever  that  time  has  had  anything  to  do  with  the  protecting  influence  of  vac¬ 
cine  ;  but  much  that  it  depends  almost  entirely  upon  the  efficiency  of  the  first  vaccination.  It  is,  however, 
proper  to  vaccinate  again  and  again,  as  we  have  no  criterion  to  go  by  but  the  repeated  refusal  of  the  system 
to  receive  it. 

It  has  been  curious  to  see  how  the  epidemic  constitution  of  the  atmosphere  has  gradually  deepened.  It 
seems  now  to  be  breaking  through  all  barriers.  Some  few  have  been  attacked  twice  within  three  months  by 
varioloid— many  have  had  varioloid  who  have  been  vaccinated  again  and  again — the  vaccine  has  taken  either 
well,  or  in  spurious  form,  in  some  who  had  rejected  re-vaccinations  repeatedly  before .  In  those  who  had  never 
been  vaccinated  the  vaccine  has  taken  mildly  and  well,  and  the  same  matter  has  made  very  sere  arms  in 
those  previously  vaccinated. 

Another  interesting  fact  has  been  witnessed  in  attacks  of  small-pox  in  individuals  while  under  the  influ¬ 
ence  of  vaccination. 

Instances  have  been  seen  by  our  physicians  in  which  the  small  pox  has  broken  out  in  subjects  in  all 
stages  of  vaccination,  and  within  two  or  three  weeks  after  vaccination  has  run  its  course  through .  There 
has  been  uo  fixed  rule  in  the  conduct  of  the  small-pox  under  these  circumstances,  and  no  conclusion  aprirori 
could  be  formed  as  to  the  violence  op  the  attack.  Most  of  the  attacks  of  small-pox,  while  undergoing  the 
influence  of  vaccine,  assumed  the  form  of  varioloid,  but  soane  have  been  genuine  and  fatal  small-pox. 

It  has  been  curious,  too,  to  witness  the  infinite  grades  of  those  vaccinated.  I  have  seen  cases  of  vario" 
loid  with  a  single  pustule — some  five,  ten  or  twenty,  and  so  on,  until  the  disease  was  lost  in  true  small-pox. 
Gen.  Withers  had  all  the  premonitory  fever  and  other  symptoms  for  four  days,  when  a  single  well  marked 
vesicle  appeared  on  the  forearm,  and  ran  its  course  with  all  the  characteristic  marks  of  variola. 

In  connection  with  one  of  the  points  above  alluded  to,  viz:  the  power  of  the  system  to  resist  morbid 
poisons  when  forced  upon  it,  as  is  the  case  of  vaccination,  I  will  quote  a  very  interesting  paragraph  from  the 
Annuaire  Encyclopedique,  for  1864 : 

Hntil  recently,  it  has  been  believed  that  the  vaccine  virus  formed  a  characteristic  vesicle.  JNo  natter 
what  the  diathesis  or  condition  of  the  subject  producing  it  might  be,  the  vims  was  always.  the  same,  and 
could  be  u  >ed  for  propagation  in  others  with  impunity.  In  other  words,  that  the  vaccine  virus  in  passing 
through  a  body  could  not  be  contaminated  by  any  constitutional  taint,  and  thus  engender  any  other  disease, 
such  as  syphilis,  scrofula,  etc.  ,  .  _  . 

“  Such  was  the  generally-received  opinion,  *’  says  the  extract,  “when  it  was  ascertained  at  Hivalta,  m  Italy, 
jn  the  first  series  of  46  children  vaccinated  the  twenty-third  May,  1861,  with  matter  furnished  by  the  vaccine 


350 


Spurious  Vaccination  :  Joseph  Jones ,  ill.  1). 


pustules  of  an  infant  named  Chiabrera,  who  seemed  healthy,  and  in  a  second  series  of  17  children  vaccinated 
with  the  pus  taken  from  one  of  the  children  of  the  first,  there  had  occurred  symptoms  of  syphilis  in  37  chil¬ 
dren  of  the  first  series,  and  in  seven  of  the  second  series;  then  propagation  of  the  infection  to  the  mothers 
and  to  the  nurses.  Several  of  these  infants  died  ;  several  were  fortunately  cured.  It  was  Dr.  Cerise  who 
first  made  these  facts  known  in  France.” — Union  Medicale,  t.  xii. 

“  This  caused  equal  surprise  in  France  and  Italy.  The  first  impulse  was  to  doubt.  It  was  also  the  sub' 
ject  of  very  serious  investigation,  which  left  no  doubt  either  as  to  rhe  reality  of  this  sad  experience,  or  as  to 
the  origin  of  the  syphilis  itself.  Was  it  then  necessary  to  admit  that  two  poisons  so  unlike  could  combine? 
On  the  other- hand',  why  had  a  certain  number  of  the  children ,  both  of  the  first  and  second  series ,  escaped  the 
infection — why  had  it  been  more  powerful  in  some  than  in  others?  Several  physicians  supposed  that  the  in¬ 
fection  had  been  transmitted  by  the  blood,  which  is  so  often  mingled  with  the  vaccine,  especially  when  the 
pustules  are  drained  to  the  extent  which  had  been  necessary,  in  order  to  perform  such  a  large  number  of 
vaccinations,  The  discussion  was  long  and  earnest.  The  result  a  resume  of  all  the  previous  forgotten  or 
unappreciated  facts  of  the  part  touching  the  transmission  of  syphilis  by  vaccination,  or  by  blood.  Dr. 
Yennois  was  the  principal  promoter  of  the  opinion,  which,  in  the  case  of  vaccination,  attributed  to  the  blood 
alone  the  faculty  of  transmission .  He  called  to  mind  that  previously  to  the  facts  of  Eivalta  he  had  pub¬ 
lished  a  memoir  on  this  subject.  Still,  the  doubt  remained,  the  observations  were  not  sufficiently  precise, 
the  facts  could  be  explained  in  another  way.  It  remained  to  make  direct  experiments  as  to  the  possibility 
of  syphilitic  infection  by  a  minute  quantity  of  the  sanguine  fluid.  This  direct  experiment  was  made  at 
Florence  by  Dr.  Pellizari  on  medical  students  who  volunteered  for  the  purpose.  He  proved  that  a  few 
drops  of  hlood  are  sufficient  to  transmit  syphilis.  Thus  it  has  been  demonstrated  that,  to  explain  the 
facts,  it  is  necessary  to  admit  the  mixture  or  composition  of  the  two  poisons,  which  upset  all  previous  no¬ 
tions.  It  is  also  demonstrated  that  the  fresh  sanguine  particles  borne  on  the  vaccinating  lancet,  at  the 
same  time  with  the  vaccine,  may  transmit  the  syphilitic  infection.  From  these  facts  it  results  that  in 
future  we  should  inquire  with  great  care  into  the  previous  history  of  those  children  from  whom  we  select 
our  protecting  virus,” 

How,  gentlemen,  these  facts  are  set  forth  with  a  fullness  of  detail  and  a  weight  of  authority  that  chal¬ 
lenge  belief,  and  if  borne  out  by  future  investigations  are  of  immense  practical  value.  In  the  present  stage 
of  the  question  it  is  our  duty  to  take  the  benefit  of  every  doubt  and  use  the  utmost  precaution  in  selecting 
the  virus  we  employ,  and  in  removing  it  from  the  arm  from  which  it  is  selected  without  its  being  contami¬ 
nated  by  a  particle  of  blood.  There  is,  I  think,  another  important  point  to  be  attended  to,  and  it  is  this. 
When  we  vaccinate,  the  lancet  always  draws  more  or  less  blood,  Not  only  should  the  lancet  be  thoroughly 
cleansed  before  it  is  used  on  another  subject,  but  the  identical  matter  should  not  be  used  on  a  second  sub¬ 
ject.  We  ordinarily  mix  the  dry  scab  in  this  country  with  water  on  a  piece  of  glass,  and  in  the  process  of 
vaccinating  a  child  the  lancet  is  dipped  several  times  into  the  mixture,  thus  necessarily  adding  to  it  some 
particles  of  blood.  In  this  state  another  piece  of  glass  is  ordinarily  placed  over  the  one  on  which  a  part  of 
the  virus  just  used  remains,  and  is  carried  about  in  the  pocket  for  a  day  or  two,  or  more,  to  be  remoistened 
and  used  again  on  others.  Now,  to  my  mind,  there  are  two  strong  objections  to  this  method.  1.  The  virus 
is  thus  contaminated  with  blood.  2.  From  being  kept  in  this  moist  state  it  becomes  putrid,  and  not  only 
fails  to  produce  a  good  vesicle  in  succeeding  subjects,  but  may  hazard,  from  its  putridity,  the  production  of 
spurious  vaccine,  followed  by  bad  sores  and  even  symptoms  notunlike  dissection  wounds.  I  throw  these 
hints  out  for  further  investigation. 

I  beg  leave  to  add  to  the  above  an  extract  translated  from  the  “  Annuaire  de  Medecine  et  de  Chirurgie,” 
1864,  which  will  be  found  interesting  in  connection  with  the  above  at  this  time: 


“  SYPHILITIC  VACCINE  AND  THE  MEANS  OF  PREVENTING  IT.” 

“  The  contagiousness  of  the  blood  plasma  being  demonstrated  to  his  satisfaction,  as  to  the  congenital  con- 
tamination  of  lhe  infant  by  the  mother,  M.  Laroyenne  admits  in  like  manner  the  contagiousness  of  the  serum 
that  transudes  under  the  vaccine  pustule,  and  mingles  with  the  vaccine  without  the  possibility  of  being  dis¬ 
tinguished.  Hence  a  new  danger  outside  of  the  blood,  and  the  vaccinal  chancre,  which  cannot  be  avoided, 
except  by  most  scrupulous  examination  of  the  subject  from  which  it  is  taken,  and  of  the  mother  if  it  is  not 
too  old.  The  subject  vaccinated  itself  should  not  be  overlooked,  for  it  may  also  be  a  source  of  infection, 
according  to  the  same  author.  In  a  collection  of  children  to  be  vaccinated,  if  there  be  one  infected,  a  com¬ 
mon  lancet  impregnated  with  his  blood  may  communicate  syphilis  to  all  those  vaccinated  after  him,  and  to 
the  subject  from  which  the  vaccine  is  taken.  (Gaz.  de  Lyon ,  No.  12.)  All  this  is  possible,  without  doubt, 
but  is  not  demonstrable,  and  is  not  even  probable;  for  if  the  syphilis  had  so  many  chances  of  being  commu¬ 
nicated  by  vaccination,  would  it  not  he  more  frequent? 

Without  deciding  on  this  accessory  question,  M.  Dupaul,  in  making  this  important  subject,  the  principal 
object  of  his  annual  report  on  vaccine  to  the  Academy  of  Medicine,  has  recognized  the  reality  of  the  trans¬ 
mission  of  syphilis  by  vaccination.  Doubtless  a  discussion  will  clear  up  the  points  in  dispute.”  * 

“  Taccine-bearing  Heifers. — There  exists  in  Naples,  says  M.  Palasciano,  besides  the  official  vaccine  insti¬ 
tute  for  vaccinating  from  arm  to  arm,  an  establishment  of  Dr  Galbiate,  where  the  cow-pox  is  propagated 
through  heifers,  in  sufficient  number  to  supply  many  vaccinations.  When  it  is  wished  to  have  a  child  vac¬ 
cinated,  one  of  these  heifers  is  driven  to  the  door,  the  conductor  cuts  out  a  pustule  entire  with  a  pair  of 
scissors  and  hands  it  with  a  pair  of  forceps  to  the  physician  who  executes  the  vaccination.  The  whole 
costs  one  dollar.  This  plan  is  also  used  in  the  army  and  colleges,  and  vaccination  from  arm  to  arm  is  prac¬ 
ticed  little  exceptamong  the  poor.  (Tongrds  de  Lyon. 

It  is  desirable  that  similar  establishments  should  be  founded  in  France,  as  it  would  be  the  surest  means  of 
escaping  syphilitic  vaccine. — Union  Med.  de  la  Seine  Inf.  p.  193. 

M  .  Lanoix,  who  went  to  Naples  to  study  this  mode  of  animal  vaccination,  has  tested  it  successfully  and 
publicly  at  Lyons.  He  vaccinated  a  heifer  of  nine  months  old,  in  the  iliac  region  and  at  the  proper  time 
transferred  the  matter  to  the  arms  of  children.  But  we  must  not  pass  over  another  curious  extract,  which 
is  as  follows : 

The  milk  of  cows,  submitted  to  this  inoculation,  would,  according  to  Dr.  Soubie,  of  Leghorn,  have 
another  advantage,  By  drinking  the  milk  during  the  course  of  the  inoculation,  all  the  benefits  of  vaccina¬ 
tion  are  obtained.  He  inserted  the  vaccine  into  the  teat  of  a  cow,  and  two  fine  pustules  being  developed,  he 
made  two  children  drink  the  milk.  One,  six  months  old,  nourished  by  the  bottle,  took  600  grammes  in  two 
days,  the  fifth  and  sixth  of  the  vaccine :  the  other,  aged  fourteen  months,  weaned,  drank  only  half  this 
quantity  on  the  eighth  day  of  the  vaccine  A  month  after,  having  attempted  to  vaccinate  them  from  an 
arm,  they  refused  it,  while  the  same  matter  succeeded  perfectly  in  another  inoculated  at  the  same  time.” 

These  statements,  to  say  the  least,  are  interesting,  and,  coming  from  sources  of  high  respectability,  de¬ 
mand  examination. 

I  have  do  data,  by  which  to  form  an  opinion,  as  to  the  relative  frequency 
and  nature  of  the  foul  gangrenous  ulcers  attendant  upon  vaccination  in 


Spurious  Vaccination :  Joseph  Jones,  M.  D. 


351 


the  United  States  forces.  In  the  second  section  of  the  present  inquiry,  we 
have  quoted  the  testimony  of  Dr.  Hamilton  to  show  that  they  were,  to  a 
great  extent,  as  in  the  Confederate  Army,  referable  to  the  depressed  aud 
scorbutic  condition  of  the  soldiers. 

Dr.  Woodward,  in  Circular  No.  6.  War  Department,  Surgeon-General’s 
Office,  p.  127,  affirms  that  the  accidents  attendant  upon  vaccination  in  the 
United  States  Army,  were  generally  regarded  by  the  Medical  officers,  as 
il  the  expression  of  scorbutic  or  other  cachectic  conditions  of  the  patients, 
and  not  due  to  any  poisonous  admixture  with  the  vaccine  virus  ;  and  it  was 
frequently  observed  that  the  same  scab  which  had  produced  a  number  of 
successful  vaccinations,  would,  in  other  men  vaccinated  at  the  same  time, 
produce  the  ulcers  referred  too.” 

It  appears,  however,  that  some  of  the  United  States  Medical  officers  held 
that  a  portion  at  least  of  these  abnormal  affections  following  vaccination, 
were  due  to  the  admixture  with  the  syphilitic  poison,  as  will  be  seen  by  the 
following  extracts  from  an  article  on  Spurious  Vaccination,  by  Geo.  H. 
Hubbard,  M.  D.,  late  Brevet  Lieut.-Col.,  and  Surgeon  U.  S.  Vols.,  published 
in  the  Philadelphia  Medical  and  Surgical  Reporter,  February  10, 1866,  p.  103. 

On  the  last  day  of  November,  1863,  I  reached  Fort  Smith,  Arkansas,  under  an  assign¬ 
ment  to  duty  as  Medical  Director  of  the  Army  of  the  Frontier. 

My  attention  was  immediately  called  to  several  hundred  men  disabled  in  consequence 
of  spurious  vaccination,  aud  a  board  of  medical  officers  was  soon  after  organized,  by  com¬ 
mand  of  Major  General  Schofield,  to  investigate  its  origin,  etc. 

This  Board  made  a  detailed  report,  from  which,  from  reports  of  other  medical  officers, 
and  from  personal  observation,  1  was  enabled  to  arrive  at  the  following  facts  and  conclu¬ 
sions. 

It  was  definitely  ascertained  that  the  virus  which  caused  all  these  cases  came  from  per¬ 
sons  who  had  been  vaccinated  in  the  rebel  army,  or  by  rebel  surgeons. 

This  virus  was  used  by  ignorant  medical  officers  aud  by  self-inoculation  among  the  men, 
till  more  than  five  hundred  were  infected. 

The  Board  reported  that — “  Soon  after  the  operation  was  performed,  the  points  at 
which  the  matter  was  inserted  commenced  to  itch  and  inflame,  and  by  the  second  or  third 
day,  pustules  were  formed,  of  a  yellowish  color,  which  rapidly  increased  in  size,  and  in 
a  few  days  hurst.  In  some  a  scab  formed,  but  in  all,  open  ulcers  were  formed  by  the 
tenth  day  and  which  furnished  a  thin  ichorous  discharge. 

“At  the  time  we  examined  the  patients,  some  had  well  marked  Hunterian  chancre; 
some  had  large  excavated  ulcers,  with  edges  elevated  above  the  raw  and  surrounding 
induration  ;  the  centres,  when  not  recently  cauterized,  were  of  a  brownish  hue — some, 
whose  primary  ulcers  were  about  healed,  had  secondary  symptoms,  such  as  swelling  and 
ulceration  of  the  glands  in  different  parts  of  the  body;  while  others  had  pain  and  stiffen¬ 
ing  of  the  joints. 

“The  disease  was  brought  to  the  First  Arkansas  Infantry  by  deserters  from  the  Confed' 
erate  army,  and  in  our  opinion  is  syphilis.” 

The  following  is  from  my  official  report  to  the  Surgeon  General : — “I  have  no  reason  to 
believe  that  in  any  one  case  did  this  virus  produce  a  true  vaccine  pustule,  or  had  any  one 
of  the  protecting  powers  of  vaccination. 

“  The  ulcers  all  possessed,  in  a  greater  or  less  degree,  the  well  established  peculiarities 
of  venereal  chancre,  beiugof  a  specific  and  progressive  nature,  spreading  in  some  cases  to 
the  size  of  a  dollar,  but  usually  about  half  that  size  ;  commonly  round  in  shape,  hut  often 
irregular,  and  usually  of  the  depth  of  the  true  skin. 

“All  had  ragged,  elevated,  indurated,  aud  overhanging  edges,  little  sensitive  to  the 
touch  or  even  to  caustics  ;  while  the  bottom  of  the  ulcer,  (especially  under  these  indurated 
edges),  was  excessively  sensitive. 

“All  discharged  dark  ill-conditioned  pus,  which  in  many  cases  caused  painful  excoria¬ 
tion  of  the  surrounding  skin,  aud  when  transferred  to  other  parts  of  the  body,  reproduced 
ulcers  like  the  original ;  iu  this  way,  chancres  were  produced  on  the  penis  in  several 
cases. 

“Cases  precisely  similar  occurred  in  the  Indian  Brigade,'  stationed  at  Fort  Gibson,  in 
the  Cherokee  nation. 

“Acting  Assistant  Surgeon  Miller,  on  duty  at  that  post,  reported  as  follows: 

“  Besides  the  cases  occurring  among  the  troops,  it  has  spread  among  the  people  to  an 
alarming  extent  by  self-inoculation. 

“In  a  large  proportion  of  the  cases,  consecutive  symptoms  have  appeared;  suppuration 
of  the  lympathic  glands  iu  the  axilla,  sore  throat,  exanthematous  eruptions,  etc. 


352 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


“Tlie  cases  occurring  among  the  troops  have  received  the  ordinary  treatment  for 
syphilis,  and  in  most  cases  with  excellent  results. 

'  “  The  mischief  was  wide  spread  before  the  true  character  of  the  disease  was  recognized, 
so  that  few  cases  have  had  prompt  abortive  treatment,  and  many  are,  in  consequence, 
permanently  disabled. 

“  Nearly  every  case  has  required  constitutional  treatment,  in  addition  to  local  treat¬ 
ment  of  the  chancre. 

“The  milder  caustic  applications  proving  insufficient,  in  many  cases,  acid  nitrate  of 
mercury  was  used  to  clear  away  the  indurated  edges,  when  the  ulcer  usually  healed  rap¬ 
idly  under  mildly  stimulating  applications.” 

“  Six  cases  of  well  marked  small-pox  occurred  in  men  who  had  suffered  severely  from 
this  venereal  inoculation. — Med  and  Surg.  Reporter, — February,  19,  1866, — p.  103. 

Up  to  the  commencement  of  the  recent  civil  war,  the  belief  was  almost 
universal  that  secondary  syphilis  could  not  thus  be  communicated  by  vac¬ 
cination. 

In  the  papers  relating  to  the  history  and  practice  of  vaccination,  con¬ 
tained  in  the  report  of  the  General  Board  of  Health,  presented  to  both 
Houses  of  Parliament,  by  command  of  Her  Majesty — London,  1857 — Mr. 
Simon  called  for  the  opinion  of  the  profession  at  home  and  abroad  on  the 
general  question. 

u  Have  you  any  reason  to  believe  or  suspect  (a)  that  lymph  from  a  true 
Jennerian  vesicle  has  ever  been  a  vehicle  of  syphilitic,  scrofulous  or  other 
constitutional  infection  to  the  vaccinated  person  ;  (b)  or  that  unintentional 
inoculation  with  some  other  disease,  instead  of  the  proposed  vaccination, 
has  occurred  in  the  hands  of  a  duly  educated  medical  practioner  V1 

In  answer  to  this  question  a  writer  in  the  British  and  Foreign  Medico- 
Chirurgical Review  (October,  1857,  Review  3,  Small  pox  and  Vaccination ), 
quotes  the  opinion  of  Hebra,  which  may  be  taken  as  expressing  in  a  logical 
and  lucid  manner,  the  belief  of  the  majority  of  the  medical  profession  at 
that  time. 

This  widely-grasping  question  (says  Hebra)  requires  several  separate  answers,  because 
queries  are  made — 

“  1.  Whether  the  lymph  of  a  vaccine  vesicle  may,  besides  its  peculiar  virus ,  contain  another 
infectious  principle — e.  g.,  that  of  syphilis  f 

“2.  Whether  constitutional  non-inf ccting  diseases,  as,  for  instance,  scrofula,  may  be  trans¬ 
mitted  by  the  inoculation  of  cow-pox  matter  f 

“3.  Whether  a  vaccine  vesicle  possesses  such  characters  that  it  may  easily  be  distinguished 
from  other  similar  vesicles,  blebs' or  pustules  f 

“(I)  The  transmissible  infectious  principles  which  have  hitherto  been  recognized,  by 
means  of  inoculation,  are  the  syphilitic  virus  contained  in  the  pus  of  a  chancre  ;  and  the 
virus  contained  in  the  cow-pox  vesicle  and  the  small-pox  pustule.  The  question,  there¬ 
fore,  simply  is,  whether  these  morbid  poisons  have  ever  been  mixed?  Whether  inocula¬ 
tion  has  ever  taken  place  with  such  a  mixture  ?  And  what  results  were  obtained  by  such 
an  operation?  It  is  well  known  that  compendious  answers  have,  for  some  time  past,  been 
offered  to  these  questions,  chiefly  the  result  of  Sigmund’s  experiments.  These  answers 
agree  in  the  following  respects: 

“Inoculation  with  secretions  of  this  kind,  viz:  containing,  as  it  were,  several  special 
poisons,  either  produced  no  effect  at  all,  or  only  generated  a  chancre,  by  inoculating  a 
mixture  of  pus  from  the  chancre  and  vaccine  lymph;  and  only  cow-pox,  by  inoculating 
a  combination  of  vaccine  lymph  and  blenorrhagic  matter.  Hence,  one  morbid  state  only 
was  produced,  either  cow-pox  or  syphilis  ;  the  latter  circumstance  being  a  proof  that  both 
poisons  are  not  simultaneously  transmissible.  This  opinion  is  supported  by  the  experience 
of  Heim,  Ricord,  Bousquet,  Taupin,  Landouzy,  Friedenger,  etc. 

“(II).  It  is  maintained  in  many  quarters  that  the  blood  of  persons  suffering  from  sec¬ 
ondary  syphilis  may  serve  as  a  vehicle  to  the  infectious  principle ;  but  were  even  this 
theory  found  correct,  it  would  have  no  prejudicial  effect  on  the  practice  of  vaccination, 
because  we  know  from  experiments  made  for  the  purpose  (Heim),  and  from  accidental 
inoculation,  that  regardless  of  the  quality  of  vaccine  lymph*,  the  latter  may  be  inoculated 
from  syphilitic  upon  sound  individuals ;  and  on  the  other  hand,  from  sound  subjects  upon 
such  as  are  under  the  influence  of  systemic  syphilis,  without  propagating  syphilis  along 
with  the  cow-pox. 

“What  has  here  been  proved  of  syphilis,  must,  a  fortiori,  hold  good  as  regards  other 
constitutional  morbid  states,  as  direct  inoculations  with  the  secretions  peculiar  to  these 
diseases  have  always  yielded  a  negative  result. 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


353 


“  But,  although  it  is  abundantly  proved  that  scrofula,  tubercular  affections,  rickets, 
cancer  and  other  blood  diseases  canuot  be  transmitted  by  means  of  their  own  secretions, 
or  along  with  the  vaccine  lymph,  we  should  nevertheless,  if  possible,  avoid  vaccinating 
diseased  persons,  because  experience  has  taught  us,  as  regards  adults  and  children,  that 
the  phenomena  of  vaccination  may  awake — i.  e.,  render  worse — dormant  affections;  and 
that,  moreover,  the  cow-pox  vesicle  easily  degenerates  upon  such  individuals.  These 
latter  vesicles  are,  nevertheless,  adapted  for  further  propagation,  even  when  they  take 
an  imperfect  development,  because  a  positive  result,  a  regular  development  of  the  ves¬ 
icle,  and  sufficient  protection  against  small-pox,  have  been  observed  in  cases  where  vac¬ 
cine  lymph  was  transferred  from  weakly,  scrofulous  and  rickety  subjects  upon  perfectly 
sound  individuals. 

“  (III.)  Every  morbid  appearance  on  the  cutaneous  envelope  has  its  own  peculiar 
characters,  by  which  it  may  be  distinguished  from  all  other  similar  phenomena ;  the  vac¬ 
cine  vesicle  presents,  in  the  like  manner,  sufficiently  striking  peculiarities  as  to  form, 
size,  number,  locality  and  peculiarity  as  regards  its  course,  to  enable  the  observer  easily 
to  establish  a  distinction  between  the  same  and  other  vesicular,  bullar  or  pustular 
eruptions.” 

In  1856  Mr.  Simon,  the  medical  officer  of  the  Board  of  Health,  addressed 
a  circular  to  members  of  the  medical  profession  in  England  and  other  coun¬ 
tries,  as  well  as  to  the  foreign  governments,  inquiring,  among  other  things, 
4t  whether  they  had  any  reason  to  believe  or  suspect  that  lymph  from  a  true 
Jennerian  vesicle  has  ever  been  the  vehicle  of  syphilitic  infection.” 

From  the  very  large  number  of  replies  which  Mr.  Simon  obtained,  we 
select  or  condense  the  following  : 

Mr.  Acton— “  1  unhesitatingly  affirm  that  I  have  never  witnessed  a  single  case  that  will 
bear  out  the  supposition.  Although  I  have  for  a  long  time  been  convinced  that  infec¬ 
tion  cannot  be  thus  introduced  into  the  system,  I  have  never  felt  myself  justified  in 
directly  vaccinating  healthy  children  from  the  virus  of  vesicles  obtained  from  syphilitic 
infants.” 

Dr.  Addison — “  To  both  these  propositions  my  own  experience  would  return  a 
negative.” 

Dr.  Alderson — ‘‘No;  hut  as  a  commissioner  of  the  Vaccine  Board,  I  am  aware  of  a 
single  instance,  some  years  ago,  of  bad  results  following  vaccination  with  a  lancet  ascer¬ 
tained  to  have  been  foul  and  accidently  used  in  ignorance.” 

Dr.  Balfour — “  In  no  instance  (in  army  vaccination  during  eight  years)  did  any  symp¬ 
toms  ever  occur,  or  any  appearance  present  itself,  which  could  lead  to  the  suspicion 
that  the  lymph  had  been  the  vehicle  of  syphilitic,  scrofulous  or  other  constitutional  affec¬ 
tion.” 

Dr.  Barlow — “I  have  no  certain  proof  that  it  is  even  the  vesicle  of  such  infection, 
though  I  have  suspected  it  in  the  case  of  syphilis.” 

Dr.  Beatty — “I  do  not  think  such  a  thing  possible.” 

Dr.  Bright — “  I  have  never  seen  such  a  case.” 

Dr.  Brinton — “  No.” 

Sir.  B.  Brodie — “I  have  no  reason  to  believe  that  vaccination  was  ever  the  means  of 
introducing  syphilis,  or  scrofula,  or  any  other  constitutional  disease  into  the  system.” 

Dr.  George  Burrows — “  I  have  no  reason  to  believe  or  suspect  that  the  true  vaccine 
lymph  has  ever  been  a  vehicle  of  syphilitic,  scrofulous  or  other  constitutional  infection 
to  the  vaccinated  person  ;  but  I  do  fear  and  suspect  that  unintentional  inoculation  with 
some  other  matter  than  the  true  vaccine  lymph  has  occurred  in  the  hands  of  legally 
qualified  medical  practitioners.” 

Mr.  George  Busk — “  I  have  never  witnessed  any  circumstance  which  could  lead  to  such 
a  belief  or  suspicion.” 

Mr.  Ceely— “  Although  I  have  heard  of  such  events,  I  have  never  witnessed  anything 
of  the  kind  in  my  own  practice  of  more  than  thirty-five  years.” 

Sir  James  Clark--“  I  see  no  reason  to  believe  the  occurrence  of  either  circumstance.” 
Sir  Philip  Crampton--'1 1  have  no  reason  to  believe  that  lymph  from  a  true  Jennerian 
vesicledras  ever  been  the  vehicle  of  any  other  disease.” 

Mr.  Theodore  Davis — “I  have  never  seen  (and my  observation  extends  over  some  thou¬ 
sand  cases)  the  slightest  reason  to  suspect  that  any  other  disease  has  been  communicated 
by  vaccination.” 

Mr.  Erichsen — “I  do  not  believe  that  any  constitutional  disease  can  be  communicated 
through  the  medium  of  vaccine,” 

Dr.  Arthur  Farr,  Dr.  Robert  Ferguson,  Dr.  Greenhill,  and  Mr.  Thomas  Hunt  answered 
in  the  negative. 


354 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


Sir  William  Jenner — “In  the  discharge  of  my  duties  as  Physician  to  University  Col¬ 
lege  Hospital  and  the  Hospital  for  Sick  Children,  I  must  have  had,  during  the  last  six 
years,  more  than  thirteen  thousand  sick  adults  and  children  under  observation  ;  and  in 
no  case  have  I  reason  to  believe,  or  even  suspect,  that  any  constitutional  taint  had  been 
conveyed  from  one  person  to  another  by  vaccination,  or  that  any  other  disease  bad  been 
unintentionally  inoculated.” 

Mr.  Jones,  of  Chesterfield — “During  the  past  six  years,  I  find  I  have  vaccinated  almost 
1,052  children.  The  result  of  my  experience  leads  me  positively  to  state  that  in  no  in¬ 
stance  have  I  seen  a  true  Jennerian  vesicle — the  vehicle  of  syphilitic,  scrofulous  or  other 
disease.” 

Dr.  P.  M.  Latham — “  I  have  never  met  with  the  slightest  proof  of  it;  and  the  sugges¬ 
tion  of  its  being  possible  amazes  me.” 

Sir  Charles  Locock  and  Mr.  Lord  answered  in  a  like  negative  manner. 

Mr.  Marson — “  I  have  no  reason  to  believe  or  suspect  that  lymph  from  a  true  Jennerian 
vesicle  has  ever  been  a  vehicle  of  syphilitic,  scrofulous  or  other  constitutional  infection 
to  the  vaccinated  person.  I  answer  on  this  point  from  the  experience  of  having  vaccin¬ 
ated  upwards  of  40,000  persons. 

Dr.  Noble,  of  Manchester;  Dr.  Kobertson,  of  Manchester;  and  Dr.  Stokes,  of  Dublin  ; 
replied  decidedly  in  the  negative. 

Mr.  Tompkins — “After  an  experience  of  twenty-one  years  as  a  vaccinating  sur¬ 
geon,  and  having  vaccinated  upwards  of  40,000  children,  I  have  never  known  syphilitic* 
scrofulous  or  other  constitutional  affection,  to  be  communicated  by  the  operation.” 

Mr.  B.  Travers — “My  experience  has  not  furnished  me  with  reason  to  believe  that 
the  true  Jennerian  vesicle  has  ever  been  a  vehicle  of  syphilitic,  scrofulous  or  other  consti¬ 
tutional  infection.” 

Sir  Thomas  Watson — “  I  have  never  had  any  reason  to  believe  or  suspect  that  lymph 
from  a  true  Jennerian  vesicle  has  ever  been  a  vehicle  of  syphilitic,  scrofulous  or  other 
constitutional  affection.” 

Dr.  West — “None  whatever,” 

Dr.  C.  J.  B.  Williams— “  I  do  not  recollect  an  instance  in  my  own  experience  in  which 
such  untoward  results  have  followed  vaccination,  but  I  have  heard  of  such,  and  I  cannot 
but  think  that  they  were  not  the  necessary  consequences  of  vaccination,  but  of  its  indis¬ 
criminate  and  careless  performance,  as  in  taking  the  virus  from  the  diseased  subjects.” 

Mr.  Erasmus  Wilson — “  No.  I  went  frequently  with  parents  who  believed  an  erup¬ 
tion  under  which  their  child  suffered  to  have  originated  in  vaccination,  but  the  origin 
was  in  reality  traceable  to  a  different  source.” 

On  the  other  hand,  the  following  surgeons  and  physicians  testified  to  their  belief  that 
syphilis  might  be  communicated  by  vaccination  : 

Mr.  Ackerly,  of  Liverpool — “  I  have  no  doubt  that  syphilis  has  been  communicated 
from  a  diseased  to  a  healthy  child  by  means  of  vaccination.” 

Dr.  J.  R.  Bennett — “I  have  suspected  that  syphilitic  disease  maybe  communicated 
by  vaccination,  and  I  would  not  willingly  sanction  vaccination  from  an  unhealthy  child, 
however  perfect  might  be  the  Jennerian  vesicle  whence  the  lymph  was  derived.” 

Dr.  Fleming,  of  Glasgow — “I  have  a  suspicion  that  I  have  once  seen  syphilitic  disease 
communicated  in  this  way,  but  it  is  a  very  difficult  point  to  ascertain  with  perfect 
accuracy.”. 

Mr.  J.  Hutchinson — “  I  believe  that  I  have  seen  four  or  five  instances  in  which  local 
syphilitic  affections  were  induced  by  vaccination,  performed  under  ordinary  circum¬ 
stances,  and  by  duly  qualified  men.  In  one  or  two  of  these  the  constitution  suffered  also, 
as  seen  by  the  appearance  of  disease  in  several  parts,  but  in  others  it  was  perceptibly  af¬ 
fected.” 

Dr.  Laycock — “  I  think  that  this  may  be  reasonably  believed  or  suspected,  and  think  a 
duly  educated  practitioner  may  be  a  negligent,  careless  or  thoughtless  practitioner,  and 
may  inoculate  unintentionally  with  some  other  disease.  Our  knowledge  of  morbid  poisons 
is  too  imperfect  to  speak  positively  as  to  what  may  happen  or  what  may  be  suspected, 
reasonably  or  not.” 

Dr.  Lever — “  I  must  say  yes .  I  have  known  syphilis  communicated  to  a  child  by  the 
hands  of  a  supposed  but  legally  educated  medical  practitioner.” 

Mr.  Martin,  of  Bristol — “  I  believe  it  is  sometimes  the  vehicle  of  communicating  the 
syphilitic  taints  to  children  previously  perfectly  free  from  it.  *  *  *  I  have 

on  many  occasions,  been  called  to  cases  of  eruption  markedly  syphilitic,  occurring  after 
vaccination,  and  in  which  I  have  failed  to  detect  the  slightest  taint  in  either  parent  or  in 
the  other  children  of  the  same  marriage.” 

Mr.  Morley,  of  Sunderland — “I  have  had  one  case  where  the  lymph,  sent  me  by  a 
medical  friend  who  is  a  public  vaccinator,  did  produce  a  syphilitic  taint'” 

Mr.  Startin — “  This  is  a  difficult  question  to  answer  satisfactorily,  as  the  reply  must 
rest  upon  what  is  regarded  as  a  ‘true  Jennerian  vesicle/ as  this  vesicle,  in  a  subject 
suffering  under  constitutional  or  acquired  syphilis,  or  from  purigo,  or  even  scabbies, 


355 


Spurious  Vaccination :  Joseph  Jones,  M.  D. 


might  be  still  a  ‘  true  Jennerian  vesicle/  though  not  a  pure  one,  and  these  maladies  I 
have  many  times  seen  transferred  from  such  a  vesicle.  I  have  also  seen  the  same  mala¬ 
dies  inoculated  by  public  vaccinators  from  unintentional  vaccination  ” 

Dr.  Whitehead,  of  Manchester — “I  have  seen  several  instances  of  the  transference  of 
the  syphilitic  taint  through  the  medium  of  vaccination,  the  lymph  having  been  taken 
from  a  true  Jennerian  vesicle,  or  presumed  to  be  so  at  least  in  a  tainted  infant.” 

The  opinions  of  the  Continental  physicians  on  this  subject  were  equally 
divided. 

Mr.  Simon’s  own  opinion  at  the  time  he  wrote  (1857)  was  that  in  the 
eases  then  on  record,  in  which  persons  pretending  to  vaccinate  did  really 
effect  a  syphilitic  inoculation,  it  is  almost  certain  that  the  matter  of  syphilis 
was  used  by  the  vaccinator  instead  of  vaccine  lymph. 

Since  the  publication  of  the  Bivalta  outbreak,  however,  Mr.  Simon  ap¬ 
pears  to  have  modified  his  opinion,  and  is  disposed  to  believe  that  cases  of 
reported  vaccine-syphilitic  inoculation  have  arisen  from  the  admixture  of 
syphilitic  matter  with  the  vaccine  in  such  manner  as  might  readily  be  com¬ 
prehended  to  occur  amongst  careless  and  dirty  people. 

We  shall  examine  these  doctrines  and  conclude  these  Researches  on  Spu¬ 
rious  V accination,  with  an  examination  of  the  following  questions : 

1.  The  possibility  of  communicating  tuberculosis  and  cancer  by  inoculation. 

2.  The  possibility  of  communicating  secondary  or  constitutional  syphilis  by 
inoculation. 

3.  The  possibility  of  communicating  the  poison  of  syphilis  through  the  medium 
of  vaccine  virus. 


INOCULABILITY  OF  TUBERCLE. 

1.  True  tubercle  is  organized ;  that  is,  it  is  composed  of  living  cells,  and 
during  its  growth  it  resembles,  to  a  certain  extent,  fresh  granulations. 
These  soft  fragile  ceils  and  nuclei,  resembling  the  gland  cells  of  the 
lymphatic  glands,  are  to  be  regarded  as  the  characteristic  living  element  of 
tubercle.  According  to  this  view,  tubercle  resembles  malignant  growths. 

M.  Yillemin’s  researches  appear  to  have  settled  the  question  of  the  in- 
oculability  of  tubercle.  This  observer  affirms  that  he  had  succeeded  in 
reproducing  tubercle  by  inoculation,  again  and  again,  in  rabbits,  not  only 
when  taken  from  the  human  subject,  but  also  when  derived  from  the  cow ; 
and  further,  that  the  tubercular  matter  thus  produced  in  one  rabbit,  could 
be  in  like  manner  transmitted  to  another.  (Gazette  Hebdomadaire,  1866. ) 

Dr.  Lebert,  professor  at  Breslau,  has  succeeded  in  introducing  tubercle 
into  the  system  by  subcutaneous  injection,  and  thus  confirmed  M.  Yille¬ 
min’s  experiments.  Dr.  Lebert’s  experiments  were  made  with  Guinea  pigs 
and  rabbits,  and  both  grey  and  yellow  matter  were  employed,  as  well  as 
liquid  from  the  cavity  ;  the  nape  of  the  neck  was  the  spot  chosen  for  in¬ 
jection,  and  the  amount  introduced  varied  from  fifty  centigrammes  to  a 
gramme,  diluted  and  triturated  with  distilled  water.  The  result  of  his  ex¬ 
periments  was  the  finding  of  tubercles  not  only  in  the  lungs,  but  in  other 
organs,  as  the  liver,  spleen,  plurae  and  pericardium.  In  some  experiments, 
the  tubercles  were  found  in  large  portions  of  the  lymphatic  system.  Mi¬ 
croscopic  examination  revealed  the  identity  of  the  tubercles  thus  formed  in 
animals  by  inoculation,  with  those  of  man. 

Tubercle  still  further  resembles  malignant  growths,  in  that  the  original 
growth  causes  the  formation  of  new  tubercles  in  its  neighborhood  and  thus 
gradually  infects  large  tracts  of  living  and  previously  healthy  tissue.  It 
is  possible  in  many  cases,  by  carefully  comparing  the  symptoms  during 
life,  with  the  results  of  post-mortem  examination,  to  trace  the  gradual 
propagation,  of  tubercle  from  a  well  defined  centre. 


356 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


The  question  of  the  contagious  or  non-contagious  nature  of  tubercles  is 
one  of  vast  importance,  as  will  be  shown  by  the  following  statistics  and 
facts : 


MORTALITY  OCCASIONED  IN  NEW  ORLEANS,  LOUISIANA,  AND 
THE  VALLEY  OE  THE  MISSISSIPPI  BY  PHTHISIS  (TUBER¬ 
CULOSIS,  PHTHISIS-PULMONALIS,  CONSUMPTION). 


During  the  first  six  months  of  1882  phthisis-pulmonalis  caused  the  fol¬ 
lowing  mortality : 


White. 

Colored. 

Total. 

38 

34 

72 

53 

35 

88 

50  ^ 

33 

73 

White. 

Colored . 

Total. 

34 

29 

63 

45 

28 

73 

44 

23 

67 

254 

182 

436 

MONTH. 


January. . 
February. 
March 


MONTH. 


April . 
May. . 
June. . 


Total. 


During  the  last  Six  months  of  1882  phthisis-pulmonalis  caused  the  fol¬ 
lowing  mortality : 


MONTH. 

White, 

Colored. 

Total. 

July . 

42 

24 

66 

August . 

37 

34 

71 

September . 

32 

23 

55 

Total,  twelve  months 


MONTH. 

White. 

Colored. 

Total. 

October . 

44 

24 

88 

November . 

43 

29 

72 

December . 

55 

34 

89 

Total . 

253 

168 

421 

507  350  857 


During  the  first  six  months  of  1882  tabes-mesenterica  caused  97  deaths — 
whites,  58;  colored,  39;  syphilis,  17  deaths — 7  whites  and  10  colored. 
During  the  last  six  months  of  1882  tabes-mesenterica  caused  63  deaths — 
whites,  55 ;  colored,  18 ;  syphilis,  17  deaths — whites,  10  ;  colored,  7.  Lep¬ 
rosy  occasioned  two  deaths,  amongst  only  whites,  during  1882. 

It  will  be  observed  from  a  critical  examination  of  the  mortuary  records 
of  1882,  that  phthisis-pulmonalis  heads  the  list  of  diseases  in  its  fatal 
effects,  occasioning  a  total  mortality  of  857 — whites,  507;  colored,  355. 
Tabes-mesenterica  caused  deaths:  whites,  113;  colored,  57 ;  total,  170. 

These  two  diseases,  phthisis-pulmonalis  and  tabes-mesenterica,  caused 
1,027  deaths,  or  more  than  one  sixth  of  the  total  mortality  of  1882. 

Relative  to  population,  phthisis  was  most  fatal  in  the  colored  race. 

During  a  period  of  thirty-four  years,  1846-1880,  10,950  cases  of  phthisis- 
pulmonalis  were  treated  in  the  Charity  Hospital  of  New  Orleans,  with  a 
mortality  of  5,600 :  51.2  per  cent. 

During  thirty-six  years,  1846-1882,  phthisis-pulmonalis  occasioned  in 
New  Orleans  25,828  deaths;  during  the  same  period  tabes-mesenterica 
occasioned,  4,950  deaths.  Total  deaths  by  these  two  diseases  during  the 
period  specified,  30,778. 

During  the  same  period,  1844-1882,  yellow-fever  occasioned  28,745  deaths. 

Those  statistics  show  that  phthisis-pulmonalis  demands  the  first  and 
highest  consideration  at  the  hands  of  the  sanitarians  and  physicians  of 
New  Orleans. 

It  is  also  worthy  of  note  that  the  mortality  occasioned  by  phthisis-pul¬ 
monalis  is  quite  uniform  throughout  the  great  Valley  of  the  Mississippi, 
with  its  20,000,000  of  inhabitants;  and  if  the  mortality  be  placed  annually 
at  500  deaths  in  every  200,000  inhabitants  (an  estimate  bel'ow  the  real  mor¬ 
tality  from  phthisis),  then  not  less  than  50,000  inhabitants  of  the  Missis¬ 
sippi  Valley  annually  fall  victims  to  phthisis-pulmonalis. 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


357 


Yellow-fever  has  only  at  long  intervals  extended  its  ravages  beyond  the 
cities  located  near  the  Gulf  of  Mexico,  and  the  most  extravagant  and  wild 
calculation  cannot  claim  a  mortality  in  1878,  when  it  is  supposed  to  have 
been  most  widely  diffused  through  the  Valley,  of  over  20,000  victims. 

After  careful  examination  of  the  statistics  of  1878,  I  am  inclined  to  place 
the  mortality  from  yellow  fever  at  not  more  than  15,000. 

Phthisis  pulmonalis  visits  annually  every  hamlet,  village,  town  or  city 
of  the  great  Valley,  and  its  causes  and  prevention  should  be  of  daily  con¬ 
sideration  ;  and  State  and  national  legislation  should  not  be  invoked  alone 
for  the  prevention  of  yellew  fever,  small-pox  and  cholera ;  neither  should 
the  truth  be  obscured,  and  national  and  State  legislation  perverted  by  a 
constant  appeal  to  popular  prejudice,  ignorance  and  fear  with  reference  to 
yellow  fever. 

The  relations  of  phthisis  to  moisture  and  to  faulty  construction  of  dwell¬ 
ings  and  to  the  low  and  badly  drained  localities  of  New  Orleans,  were  con¬ 
sidered  in  the  Annual  Eeport  of  the  Board  of  Health  of  the  State  of  Lou¬ 
isiana  for  1881 ;  see  pp.  188 — 190. 

It  is  however  of  importance  that  we  should  briefly  consider  the  condi¬ 
tions  which  give  rise  to  phthisis,  and  also  examine  the  important  question 
as  to  the  contagious  or  non-contagious  nature  of  tuberculosis. 

JETIOLOGrY  OF  PHTHISIS. 

The  conditions  which  give  rise  to  phthisis  are  varied  and  diverse,  but 
may  be  arranged  into  general  and  local  causes;  in  the  former,  the  constitu¬ 
tion  of  the  individual  and  the  functions  of  nutrition  and  assimilation 
appear  to  be  first  involved ;  in  the  latter  the  lungs  are  the  primary  seat  of 
the  disease,  and  changes  in  their  epithelia  and  parenchyma  lead  to  pro¬ 
ducts  of  a  retrograde  kind,  through  which  the  lymphatic  and  vascular  sys¬ 
tems  aud  the  constitution  generally  become  affected.  The  general  have 
been  called  constitutional  and  the  local  inflammatory. 

Dr.  O.  Theodore  Williams  and  other  systematic  medical  writers,  have 
assigned  the  following  as  the  most  important  causes  of  phthisis  ? 

1.  Family  predisposition. 

The  influence  of  heredity  as  a  cause  of  phthisis  cannot  be  doubted. 

2.  Local  infection. —  Chronic  inflammatory  affections  of  organs  and 
textures  leading  to  the  formation  of  caseous  centres. 

3.  Acute  febrile  diseases. — Continued  fevers,  measles  and  scarlatina,  act 
partly  by  exhausting  the  system,  and  partly  by  bequeathing  to  the  indivi¬ 
dual  the  legacy  of  caseous  matter,  either  in  the  lungs  or  glands,  which  form 
the  centres  of  subsequent  tuberculisation. 

Syphilis. — Syphilis  by  its  debilitating  influence  predisposes  to  phthisis ; 
but  it  also  appears  to  act  as  a  cause  capable  of  developing  a  limited  con¬ 
solidation,  and  a  form  of  a  laryngeal  phthisis,  characterized  by  ulcers  in 
the  larynx  and  pharynx. 

5.  Debilitating  conditions. — Miscarriages,  unfavorable  confinements,  over- 
lactation,  insufficient  food  and  alcoholism  are  recognized  causes  ol 
phthisis. 

6,  Bad  Ventilation. — Consumption  is  more  rife  among  persons  of  indoor 
occupations  than  among  those  employed  out  of  doors.  Of  nearly  6000  cases 
of  phthisis  admitted  into  the  Brompton  Hospital  during  ten  years,  two- 
thirds  had  indoor  occupations.  Among  them  milliners,  seamstresses  and 
tailors  furnish  the  largest  quota,  who  all  live  in  close  rooms  to  wbicb  they 
are  almost  entirely  confined.  Phthisis  frequently  attacks  printers,  com¬ 
positors,  tailors  and  tradesmen  who  live  in  hot  gas-lit  shops,  and  often  sleep 
in  miserably  ventilated  bed-rooms. 


358 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


7.  Climatic  Influence. — A  moist  atmosphere  is  more  favorable  to  the  de¬ 
velopment  of  consumption  than  a  dry  one.  Dr.  Gurlbert  has  shoyn  that 
a  combination  of  heat  and  moisture,  as  exemplified  in  the  litoral  of  Peru, 
in  the  West  Indies,  etc.,  produces  an  acute  form  of  consumption,  largely 
prevalent  in  these  districts,  attacking  the  abdominal  organ  in  addition  to 
the  lungs. 

8.  Dampness  of  Soil — The  researches  of  Dr.  Buchanan  have  demonstrated 
that  the  death  rate  from  phthisis  in  the  Districts  of  Surrey,  Kent  and 
Sussex  depend,  to  a  great  extent,  on  the  geological  formation  of  the  soil ; 
for  while  in  the  light  and  sandy  strata  deaths  from  phthisis  are  rare,  in  the 
heavy  impentrabffi  ones,  in  which  clay  predominates,  the  mortality  from 
this  cause  is  high. 

The  conclusion  that  wetness  of  soil  is  a  cause  of  phthisis  to  those  living 
on  it,  has  been  confirmed  by  the  Registrar  General  of  Scotland,  and  Dr. 
Bowditch,  of  the  United  States ;  the  latter  testifying  that  the  law  holds  good, 
not  only  as  regards  villages  and  towns,  but  even  as  regards  individual 
houses — the  houses  on  clay  becoming  the  foci  of  consumption,  whilst  others, 
but  slightly  removed  from  them,  but  on  a  dry  soil,  wholly  escape. 

The  pine  regions,  with  their  dry,  sandy,  porous  soil,  of  Louisiana,  Ala¬ 
bama,  Florida,  Georgia  and  Mississippi  are  noted  for  their  freedom  from 
phthisis,  and  are  famed  as  health  resorts  for  those  suffering  with  this  dis¬ 
ease. 

The  difference  in  the  relative  salubrity  with  reference  to  phthisis  between 
New  Orleans  and  the  neighboring  pine  hills  is  due,  not  to  variations  of 
temperature,  but  to  the  absence  of  moisture  in  the  atmosphere  and  of  water 
in  the  soil  of  the  latter. 

9.  Inoculation — From  the  time  of  Laennee  until  the  present,  experiments 
have  been  carried  on  by  numerous  observers  to  ascertain  whether  tubercle 
is,  or  is  not  inoculable;  and  the  results  of  these  experiments  prove  that 
in  guinea-pigs  and  rabbits  tubercle  can  be  produced  artificially  by  the  in¬ 
sertion  under  the  skin,  not  only  of  tubercle,  but  of  various  other  materials, 
such  as  pus,  putrid  muscle  and  diseased  liver  taken  from  non-tuberculous 
subjects.  There  was  nothing  specific  in  the  results  of  the  inoculations,  for 
the  materials  most  efficient  in  producing  artificial  tubercle  were  taken  from 
low  pneumonia,  pysemic  abscess,  etc. ;  while  human  tubercle,  phthisical 
sputa,  pus  and  putrid  muscle  were  less  successful.  It  was  found  by  Dr.  Bur¬ 
den  Sanderson  that  tuberculosis  might  be  induced  in  the  guinea-pig  by  the 
insertion  of  a  cotton  thread  under  the  skin,  but  if  the  seton  was  steeped  in 
carbolic  acid,  no  tubercle  was  produced.  To  ascertain  the  results  of  me¬ 
chanical  injury  without  exposure  to  air,  the  scapulae  of  guinea-pigs  were 
fractured  subcutaneously.  No  tuberculosis  resulted.  It  is  evident,  from 
these  experiments,  that  tubercle  is  not  so  effective  for  infective  purposes  as 
many  other  materials,  and  especially  those  of  a  septic  nature,  as  pyaemic 
pus  and  putrid  muscle.  These  facts  warrant  the  conclusion  that  tubercu¬ 
losis  is  closely  associated  with  pyaemia,  and  among  animals  the  difference 
between  these  two  diseases  would  appear  to  be  one  merely  of  degree. 

10.  Infection — The  idea  of  infection  being  the  cause  of  phthisis  has  been 
received  and  extended  in  England  and  Germany.  The  evidence  of  the 
Brompton  Hospital  negatives  the  idea  of  a  contagion  such  as  is  present  in 
small-pox  or  scarlet  fever ;  for  it  has  been  demonstrated  that  the  percentage 
of  acquired  pththisis  occurring  amongst  the  resident  staff  of  the  institu¬ 
tion  is  less  than  that  of  most  general  hospitals. 

Virchow  and  most  English  physicians  strongly  maintain  that  phthisis 
may  be  communicated  from  husband  to  wife,  and  Dr.  Herman  Weber  has 
lately  indicated,  by  some  striking  cases,  the  danger  of  pregnancy  to  the 
wife  of  a  cousumptive. 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


359 


Oohnlieira,  who  appears  to  have  confirmed  by  his  own  experiments  the 
doctrine  of  specific  infection,  holds,  in  opposition  to  the  above  views,  that 
the  test  of  tubercle  is  its  inoculability,  and  prefers  this  to  any  structural 
test.  He  considers  that  tubercular  particles  are  conveyed  by  means  of 
organisms  to  the  lungs,  thus  affecting  the  pleura  and  bronchial  glands, 
later  the  larger  bronchi.  The  infection  of  the  intestinal  canal  arises,  ac¬ 
cording  to  Cohnheim,  from  swallowing  the  sputum.* 

Dr.  Koch,  an  eminent  German  mycologist,  distinguished  for  his  classical 
work  on  anthrax  and  infectious  surgical  diseases,  has  advanced  the  view 
that  phthisis  is  of  parasitic  origin,  and  claims  that  he  has  proven  by  direct 
experiments  on  animals  that  a  certain  bacillus,  which  he  calls  bacillus  tuber¬ 
culosis ,  is  the  cause  of  this  disease. 

The  recent  appointment  of  Dr.  Koch  as  Imperial  Councillor  and  Chief  of 
the  Laboratories  of  the  National  Board  of  Health  of  the  German  Empire, 
has  given  great  weight  to  his  statements,  and  his  conclusions  as  to  the 
aetiology  of  phthisis  have  been  indorsed  by  some  distinguished  microscop- 
ists  and  physicians  in  Germany,  England  and  America.  The  news  of  this 
great  discovery  of  Koch  have  been  spread  by  the  newspapers  throughout 
all  civilized  nations. 

Recently  the  low  organism  which  is  alleged  to  be  the  cause  of  general 
tuberculosis  and  phthisis  was  exhibited  to  the  pathologists  and  physicians 
of  Philadelphia  by  Professor  Whittaker,  of  Cleveland,  O.,  by  invitation  of 
the  College  of  Physicians. 

Dr.  H.  D.  Formad,  lecturer  on  experimental  pathology  and  demonstrator 
of  morbid  anatomy  in  the  University  of  Pennsylvania,  has  also  publicly 
demonstrated,  before  the  Philadelphia  County  Medical  Society,  the  exist¬ 
ence  of  this  organism  in  the  sputum  of  patients  suffering  with  this  disease 
in  the  Philadelphia  Hospital. 

The  discovery  of  Koch  and  his  theory,  which  corresponds  with  the  pre¬ 
vailing  opinion  that  there  must  be  a  specific  poison  of  some  kind  character¬ 
istic  of  phthisis  transmissible  from  person  to  person  and  from  animal  to 
animal,  and  from  animal  to  man,  through  food,  water,  air  and  cohabitation, 
followed  to  its  logical  conclusion  leads  to  most  important  results. 

It  is  said  that  in  Germany,  by  imperial  order,  in  military  hospitals 
phthisical  patients  are  separated  from  other  cases,  as  carefully  as  small¬ 
pox  patients  ;  and  even  in  this  country  the  people  begin  to  regard  consump¬ 
tion  as  eminently  contagious. 

The  adoption  of  the  views  of  the  contagionists  will,  without  doubt,  lead 
to  much  mental  and  physical  suffering.  The  wife  will  look  with  suspicion, 
if  not  with  abhorrence,  upon  her  sick  husband ;  the  hale  and  hearty  husband 
will  abandon  his  feeble  wife ;  and  the  sick  child  will  be  isolated  and  pass 
the  remaining  days  of  suffering  in  solitude. 

During  the  experience  of  more  than  twenty- five  years  spent  mainly  in 
the  sick-room  and  in  the  wards  of  civil  and  military  hospitals,  the  opinion 
has  grown  into  a  strong  conviction  that  tuberculosis  (consumption)  phthisis 
pulmonalis  is  not  contagious  in  the  same  manner  as  small-pox,  measles  or 
scarlatina. 

The  following  conclusions  and  propositions  recently  enunciated  by  H. 
D.  Formad,  M.  D.,  of  the  Medical  Department  of  the  University  of  Penn¬ 
sylvania,  are  worthy  of  consideration,  in  connection  with  the  foregoing 
facts  : 

(a)  The  predisposition  to  tuberculosis  in  some  men  and  animals,  the  so 
called  scrofulous  habit,  lies  in  the  anatomy  of  the  connective  tissue  of  the 


*  “A  Dictionary  of  Medicine,  Including  General  Pathology,  General  Therapeutics,  Hygiene,  and  the 
diseases  Peculiar  to  Women  and  Children  by  Various  Writers.”  Edited  by  Richard  Quain,  M.  D.,  F.  R.  S. 
London:  Longmans,  Green  &  Co.,  1882.  Pp.  1166-1168. 


360 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


individual,  the  peculiarity  being’  a  narrowness  of  the  lymphatics,  and  their 
entire  obliteration  by  cellular  elements. 

(b)  Only  beings  with  such  anomalous  structure  of  connective  tissue  can 
have  primary  tuberculosis,  and  such  animals  invariably  do  become  tuber¬ 
culous  from  any  injury  resulting  in  inflammation,  although  it  may  remain 
local  and  harmless. 

(c)  Scrofulous  beings  can  have  no  other  than  a  tuberculous  inflammation, 
although  it  may  remain  local  and  harmless. 

(d)  Noil-scrofulous  men  or  animals  may  acquire  the  predisposition  to  tu¬ 
berculosis  through  mal-nutrition  and  confinement,  the  latter  bringing  on 
the  above  mentioned  peculiarities  in  the  connective  tissue. 

(e)  No  external  etiological  influences  are  necessary  to  cause  tubercular 
disease  other  than  those  which  ordinarily  produce  inflammation,  and  even 
scrofulous  beings  will  not  become  tuberculous  unless  local  inflammation  is 
set  up. 

No  inflammation,  no  tuberculosis. 

(f )  Non-scrofulous  animals,  so  far  as  can  be  established  now,  may  acquire 
tubercular  disease  through  injuries  of  serous  membranes,  viz:  peritoneum, 
pleura,  etc.  And  even  here,  without  any  special  virus  whatsoever,  clinical 
observations  on  the  post  mortem  table  show  similar  conditions,  and  prove 
the  same  in  men. 

(g)  The  bacilli ,  which  is  the  merit  of  Koch  to  have  first  proved  to  infest 
tissues  affected  by  tubercular  disease,  are  not  necessary  for  its  causation, 
even  if  a  special  organism  exist  and  be  really  possessed  of  such  property. 

The  presence  of  bacilli  is  secondary,  and  appears  to  condition  the  com¬ 
plete  destruction  of  the  tissue  already  diseased  and  infected  by  them,  and 
this  destruction  is  in  direct  proportion  to  the  quantity  of  the  organism. 

The  tuberculous  tissue  seems  to  serve  merely  as  a  nidus  for  the  growth  of 
the  bacillus. 

(li)  An  analysis  of  Koch’s  experiment  shows  that  he  has  not  proved  the 
parasitic  nature  of  phthisis,  or  that  there  exists  a  special  bacillus  tubercu¬ 
losis;  so  that  the  infectiousness  of  tubercular  disease  is  still  sub  judice. 

(i)  From  the  result  of  microscopical  and  post  mortem  observations,  and 
clinical  investigations,  the  conclusion  seems  to  be  justified  that  phthisis  is 
not  a  specific  infectious  disease;  but  that  the  individuals  suffering  from 
tubercular  disease  are  specific  themselves,  originally,  and  form  a  specific 
variety  of  mankind,  the  scrofulous. 

11.  Local  Causes — The  local  causes  of  phthisis  are  those  which  injuriously 
affect  the  bronchi  and  air  passages,  causing  large  epithelial  proliferations 
and  various  inflammatory  lesions,  followed  by  thickening  and  induration  of 
the  alveolar  walls,  and  in  time  caseation  or  fibrosis.  Bronchitis  and  pneu¬ 
monia  arfe  fruitful  sources  of  phthisis. 

12.  Trades  and  Occupations  Giving  Rise  to  a  Dusty  or  Gritty  Atmosphere. — 
The  constant  inhalation  of  particles  of  flint,  iron,  coal,  hard  clay,  and  even 
of  cotton,  flax  and  straw,  as  is  the  case  in  certain  trades — such  as  stone¬ 
masons,  fork  and  needle  grinders,  colliers,  potters,  cotton  carders,  chaff 
cutters,  and  others — has  been  shown  by  Dr.  Greenhow  to  induce  phthisis. 
The  various  irritating  particles  have  been  detected,  microscopically  and 
chemically,  in  the  lungs,  where  they  appear  to  cause  great  irritation,  fol¬ 
lowed  by  thickening  of  the  bronchi  and  subsequent  induration  of  the  lung 
tissue,  with  increase  of  pigment.  "Intermingled  in  the  consolidations  are 
found  gray  and  yellow  tubercle,  and  also  extensive  cavities,  proving  the 
identity  ot  this  disease  with  phthisis.  (A  Dictionary  of  Medicine,  etc., 
edited  by  Richard  Quain,  M.  D.;  London,  1882;  p.  1168.) 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


361 


It  is  not  my  design  to  discuss,  at  this  time,  the  cause  and  mode  of  origin 
of  tubercle,  or  its  relations  to  inflammation,  and  to  defective  nutrition;  my 
design  has  been  simply  to  show  that  there  are  facts  and  experiments  prov¬ 
ing  the  possibility  of  transmitting  the  disease  from  one  animal  to  another 
by  inoculation.  And  whilst  we  are  unacquainted  with  a  single  fact  which 
illustrates  in  any  manner  the  relations  of  vaccination  to  tuberculosis,  at 
the  same  time  it  must  be  admitted  that  we  need  farther  experiments  and 
light  upon  this  subject;  and  we  know  just  enough  to  create  a  prejudice 
against  the  indiscriminate  use  of  vaccine  matter  from  scrofulous  and  tuber¬ 
culous  subjects. 


POSSIBILITY  OF  TRANSMITTING  SCROFULA  BY  VACCINATION . 

Dr.  Edward  Ballard,  in  his  valuable  Prize  Essajr  on  Vaccination,  pro¬ 
posed  the  following  question : 

11  Is  there  any  reason  to  believe  that  scrofulous  affections  or  cutaneous  diseases  are  ever  com¬ 
municated  by  means  of  vaccination  ?” 

“  In  replying  to  this  question  we  may  freely  admit  that  sometimes  scrofulous  manifesta¬ 
tions  do  succeed  the  vaccine  disease,  and,  moreover,  that  it  is  not  a  rare  event  for  cer¬ 
tain  eruptions  on  the  skin,  such  as  eczema  or  the  ‘crusta  lactea’  of  authors,  to  appear 
shortly  after  vaccination.  But  it  does  not  follow  from  this  that  the  lymph  which  has 
been  over  it,  as  mothers  are  very  apt  to  fancy,  the  cause  of  the  attack,  or  that  it  has  been 
derived  from  an  unhealthy  child.  The  quality  of  vaccine  virus  as  we  shall  see  presently, 
is  not  regulated  by  any  special  healthiness  or  unhealthiness  of  the  child  who  furnishes 
it,  in  the  sense  that  it  partakes  in  any  way  of  that  child’s  peculiarbonstitution.  It  is  the 
same  from  a  scrofulous  or  ricketty  infant  as  from  a  robust  one;  it  is  vaccine  virus  weak¬ 
ened  and  deteriorated  somewhat,  perhaps  in  its  energy,  bur  nothing  more.  Besides,  if  it 
were  contaminated — if,  it  did  partake  of  the  constitution  of  the  vaccinifer— what  then  ? 
Is  scrofula  a  disease  capable  of  being  communicated  by  inoculation  of  a  secretion  from 
one  subject  to  another  ?  or  the  skin  diseases,  so  commonly  laid  to  the  charge  of  bad  lymph, 
capable  of  a  similar  mode  of  transmission?  Nothing  of  the  sort.  Neither  of  them  are 
contageous,  neither  of  them  inoculable — although  the  very  secretions  and  material  itself 
be  used  to  make  the  attempt  with.  These  maladies  arise  in  a  very  different  manner. 
How  scrofulous  affections  generally  arise  I  have  already  had  occasion  co  point  out ;  and  I 
have  only  to  add  that  skin  affections,  such  as  eczema,  strophalus,  etc.,  are  very  common 
diseases  in  infants  constitutionally  predisposed  to  them,  and  especially  during  dentition, 
or  when  children  are  supplied  with  food  of  an  improper  character,  or  when  cleanliness  is 
neglected.  Glandular  swellings,  also,  about  the  neck  are  often  associated,  as  a  result  of 
the  local  irritation,  with  eczema  of  the  head  and  face,  if  at  all  extensive.  And  these 
things  happen  just  the  same  in  unvaccinated  children  as  in  vaccinated  children,  and  was 
observed  just  as  often  in  the  days  when  vaccination  was  unknown  as  they  are  now  ;  and 
they  originated  then  from  just  the  same  causes  as  they  originate  in  now.  The  most  that 
can  be  said  about  their  relation  to  vaccination  is  that  the  disturbance  of  the  system  in 
the  vaccine  disease  may  sometimes,  like  any  other  constitutional  disturbance,  or  like 
small-pox  itself,  promote  or  arrest  in  the  manifestation  of  a  scrofulous  taint  if  pre-exis¬ 
tent,  or  may  arrest  other  causes  which  alone  have  been  insufficient  for  the  appearance  of 
an  eruption  on  the  skin.  I  cannot  express  the  relation  borne  by  vaccination  to  such 
outbreaks  of  cutaneous  disease  better  than -it  has  been  statedby  Mr.  Paget  : 

“When  eczema,  impetigo,  etc.,  occur,  as  in  any  sense,  a  consequence  of  vaccination,  the 
explanation  is  to  be  found  in  the  fact  that  vaccination  produces  a  certain  amount  of  fever¬ 
ishness,  and  is  followed  by  a  few  days  loss  of  strength — states  which,  though  they  are 
quite  insignificant  in  moderately  healthy  children,  are  favorable  to  the  evolution  of  any 
constitutional  disease  or  blood  disease  to  which  a  sickly  child  may  be  liable.  In  children 
and  adults  alike  it  is  certain  that  a  tendency  to  the  external  manifestations  of  eczema 
and  the  other  diseases  above  named  may  exist  for  many  weeks  or  months,  and  yet  not 
take  effect  till  some  accident  disturbs  the  health,  and  wakens,  as  one  may  say,  the  form 
of  retention  or  repression  of  the  morbid  tendency  in  the  blood.  There  is,  indeed,  scarcely 
a  blood-disease  of  which  evolution  may  not  thus  be  determined  or  hastened  by  an  acci¬ 
dental  injury,  or  by  casual  loss  of  health.  When,  therefore,  eczema,  or  any  such  disease, 
so  appears  after  vaccination  that  the  one  may  with  any  reason  be  regarded  as  the  conse¬ 
quence  of  the  other,  the  vaccination  may  be  considered  to  have  done  no  more  than  any 
accidental  injury  would  have  done.  Indeed,  even  among  ignorant  persons,  the  blame  of 
these  diseases  is  not  nearly  so  often  laid  on  vaccination  as  it  is  on  accidental  blows,  falls, 
frights,  colds,  surfeits,  and  other  such  things.  Perhaps  the  most  common  expression  of 
all  is  that  a  child  cannot  even  get  so  much  as  the  scratch  of  a  pin  but  what  it  brings  out 


362 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


an  eruption,  or  ‘is  followed  by  an  abscess.’  Now  vaccination  may  do,  though  I  believe 
it  vAy  rarely  does,  what  these  small  accidents  may  do,  namely,  by  disturbing  the  gen¬ 
eral  health  it  may  give  an  opportunity  for  the  external  manifestation  and  complete  evo¬ 
lution  of  some  coustitutinal  affection,  which,  but  for  it,  might  have  remained  rather  longer 
latant.” 

But  so  deeply  rooted  is  the  belief  in  some  minds  that,  because  these  maladies  sometimes 
succeed  the  vaccine  disease,  therefore  they  are  caussd  by  it  directly  and  solely ;  that 
rather  than  run  a  remote  risk  of  what  mostly  is  by  no  means  a  serious  ailment,  of  what 
may  occur  in  a  predisposed  child  even  if  vaccination  be  not  performed,  mothers  will  pre¬ 
fer  to  accept  for  their  offspring  the  chances  of  small-pox  and  all  its  dangers.” — Vaccina¬ 
tion  :  Edward  Ballard,  pp.  272-275. 


I N OCUL ABILITY  OF  CANCER. 

Dr.  George  Budd,  of  Loudon,  in  bis  valuable  work  on  diseases  of  the 
liver,  has  recorded  a  large  number  of  facts  to  show,  not  only  that  cancer 
may  be  disseminated  by  inoculation ,  or  by  the  mere  contact  of  a  sound  part 
with  a  part  affected  with  cancer,  without  any  direct  vascular  connection 
between  them ;  and  by  cancerous  matter  conveyed  by  lymphatics  and  veins 
to  other  parts  of  the  body ;  but  that  cancer  may  even  be  propagated  by 
inoculation,  or  by  injection  of  cancerous  matter  into  veins  from  one  animal 
to  another. 

The  facts  recorded  by  Dr.  Budd  illustrate  in  the  clearest  manner  the 
first  two  modes  of  the  dissemination  of  cancer,  in  the  human  being,*  and 
to  support  the  third  proposition  he  cites  the  following  experiments : 

Professor  Langenbeck  injected  into  the  veins  of  a  dog  some  pulp  taken 
from  a  cancer  which  had  just  been  removed  from  a  living  body.  At  the 
end  of  some  weeks  the  dog  began  to  waste  rapidly.  It  was  then  killed, 
and  several  cancerous  tumors  were  found  in  its  lungs. 

Another  instance  to  the  same  effect,  taken  from  a  German  periodical,  is 
related  in  the  Provincial  Medical  Journal  for  September  23,  1843.  Some 
cells  were  collected  from  a  black  liquid  in  the  orbit  of  a  mare  affected  with 
melanosis,  and  were  inoculated  into  the  conjunctiva  and  lachrymal  gland 
of  an  old  horse.  These  merely  caused  a  black  spot  on  the  conjunctiva, 
which  extended  very  slowly ;  but  about  the  sixteenth  week  after  inocula¬ 
tion,  melanosis  of  the  lachrymal  gland  was  very  decided ;  it  had  invaded 
the  whole  organ,  and  pushed  the  globe  of  the  eye  forward.  Some  of  the 
melanotic  matter,  taken  from  the  same  mare,  was  injected  into  the  veins  of 
the  neck  of  a  dog,  who  died  suddenly  whilst  hunting,  three  weeks  after  the 
operation.  There  was  found  in  the  left  lung  a  melanotic  tumor,  which  was 
ruptured,  and  which  contained  a  brown,  coffee-colored  fluid,  abounding  in 
cells. 

So  many  instances  have  occurred  of  cancer  of  the  penis  in  men  whose 
wives  had  cancer  of  the  womb,  that  many  physicians  have  been  led  to  be¬ 
lieve  that  the  disease  in  these  instances  was  propagated  by  contagion.  (Oil 
the  disease  of  the  liver  by  George  Budd,  M.D.,  Third  Edition,  London, 
1857,  chapter  4.,  pp.  388-416). 

It  would  in  like  manner,  be  foreign  to  our  purpose  to  enter  into  any 
speculation  as(to  the  cause  of  cancer,  or  into  an  examination  of  the  qnestion, 
whether  the  germ  of  the  disease  be  a  true  parasite,  introduced  from  with¬ 
out;  or  whether  cancer  is  generated  within  the  body,  or  of  the  materials 
of  the  body,  under  the  influences  of  certain  agencies. 

We  will  have  accomplished  our  purpose  in  recording  these  facts,  if  we 
succeed  in  directing  the  attention  of  the  profession  in  this  country,  to  the 
necessity  of  greater  attention  to  the  condition  of  the  subjects  selected  for 
the  propagation  of  the  vaccine  disease. 


Spurious  Vaccination :  Joseph  Jones ,  M. D. 


363 


II.  CONTAGIOUS  NATUKE  OF  CONSTITUTIONAL  SYPHILIS. 

We  proceed  now  to  the  consideration  of  the  second  and  more  important 
question,  which  relates  to  the  propagation  of  one  of  the  most  destructive 
poisons  in  its  action  upon  the  human  race. 

The  formal  and  persevering  denial  by  eminent  surgeons,  that  secondary 
syphilitic  disease  could  be  communicated  by  contact,  and  the  adoption  of 
this  theory  by  a  large  and  influential  school,  has  inflicted  much  domestic 
misery  and  led  to  most  unwarrantable  and  destructive  carelessness  in  the 
process  of  vaccination. 

The  question  of  the  communication,  by  contact  and  inoculation  of  secon¬ 
dary  syphilis,  is  of  vast  importance  in  its  bearing  upon  the  human  race,  and 
should  not  be  settled  dogmatically — in  fact  it  is  not  in  any  manner  a  ques¬ 
tion  of  belief,  but  of  facts. 

As  early  as  1498,  Gaspard  Torella  affirmed  that  he  had  often  seen  the 
unweaned  child  infected  by  the  sore  breasts  of  its  mother,  and  then  bestow 
upon  its  nurse,  who  fondled  and  kissed  it,  the  same  unfortunate  endow¬ 
ments. 

Many  of  the  older  writers  appear  to  have  entertained  no  doubt  with  re¬ 
ference  to  the  possibility  of  communicating  constitutional  syphiMs.  The 
following  testimony  is  from  William  Clowes,  who  wrote  more  than  two 
centuries  and  a  half  ago : 

I  have  also  kuowne  divers  persons  infected,  who  have  had  in  all  other  parts  of  the 
bodie  manifest  signes  thereof,  as  dolors,  tumors,  ulcers,  and  venemous  pustules,  etc.  And 
yet  in  the  parts  aforesaid,  no  paine,  or  any  signes  thereof;  so  that  their  opinion  is  not  to 
be  observed,  which  affirme,  that  this  disease  is  ingendred  onely,  by  the  company  of  un- 
cleane  persons  ;  for  I  have  knowne  not  many  years  past,  three  good  and  honest  midwives 
infected  with  this  disease,  called  Lues  Venerea,  by  bringing  abed  three  infected  women,  of 
three  infected  children,  which  infection  was  chiefly  fixed  upon  the  midwives,  fingers  and 
hands,  etc.  What  should  I  speake  of  young  sucking  children,  whereof  divers  have  been 
grievously  vexed  with  this  disease,  and  some  of  them  a  moneth,  two,  three  or  foure 
moneths  old,  and  some  of  them  a  year  old,  some  foure  or  five  yeares  old,  and  some  of  them 
sixe  or  seaven  yeares  old,  amongst  which  sort,  I  thought  it  good  here  to  note  a  certaine 
wench,  the  daughter  of  one  Save  of  twelve  yeares  of  age,  the  which  I  cured,  in  the  yeare 
oure  Lord  1567,  who  was  greatly  infected  with  this  sicknesse  in  many  parts  of  her  body, 
having  thereon  painfnll  nodes  or  hard  swellings  and  ulcers,  with  corruption  of  the  bones, 
and  yet  no  signe  in  the  most  suspected  parts,  neither  by  reason  of  debilitie  was  able  to 
have  committed  any  such  act,  but  it  is  not  to  be  doubted,  but  that  she  received  the  infec¬ 
tion,  either  from  the  parents,  the  which  cure  of  some  is  supposed  uncertaine,  whether 
children  bagotten  by  infected  parent  may  bee  cui'ed  or  not ;  or  else  she  was  infected,  as 
children  begotten  by  infected  parents,  may  bee  cured  or  not,  or  else  she  was  infected,  as 
divers  are,  by  sucking  the  corrupt  milke  of  some  infected  nurse,  of  whom  I  have  cured 
many,  for  such  milke  is  engendred  of  infected  blond,  and  I  may  not  here  in  conscience 
overpasse,  to  forwarne  the  geod  Reader,  of  such  lewde  and  filthie  nurses ;  for  that  in  the 
yeare  1583,  it  chanced  that  three  young  children,  all  borne  in  this  cltie  of  London,  all  of 
one  parish,  orverv  neere  together,  and  being  of  honest  parentage,  were  put  to  nurse,  the 
one  in  the  countne,  and  the  other  two  were  nursed  in  the  citie  of  London  ;  but  within 
lesse  than  lialfe  a  yeare,  they  were  all  three  brought  home  to  their  parents  and  friends, 
grievously  infected  with  this  great  and  odious  disease,  by  their  wicked  and  filthy  nurses  ; 
Then  their  parents  seeing  them  thus  miserably  spoiled  and  consumed  by  extreme  paines, 
and  great  breaking  out  upon  their  bodies,  and  being  so  young,  sick  and  weake,  impossi¬ 
ble  to  be  weaned,  were  forced,  as  nature  doth  biude,  to  seeke  by  all  meanes  possible  to 
preserve  these  poore  silly  infants,  which  else  had  died  most  pitifully.  To  be  briefe,  ere 
ever  those  children  could  be  cured,  they  had  infected  five  sundry  good  and  honest  nurses  ; 

I  cured  one  of  the  children,  and  the  nurse  which  gave  it  sucke,  the  other  two  children 
and  their  nurses  were  also  cured  by  others,  but  one  of  the  children  lived  not  long  after, 
as  I  was  given  to  understand.  Also,  friendly  reader,  I  read  of  late  in  a  certaine  history, 
w.itten  by  Ambrose  Pare,  in  his  2.  book,  intreating  of  the  causes  of  Lues  Venerea  which 
history  indeed  is  worthy  the  rehearsall :  “An  honest  citizen  saith  he,  granted  his  most 
chaste  wife,  that  she  should  nurse  the  childe  which  she  was  lately  delivered  of,  it  she 
would  keepe  a  nurse  to  be  partaker  of  the  travell  and  pains;  the  nurse  that,  she  tooke  by 
cbance,  was  infected  with  Lues  Venerea,  therefore  she  did  presently  infect  the  foster  childe, 
and  he  the  mother,  and  she  the  husband,  and  he  two  children  which  he  had  daily  at  his 
tabie  and  bed,  not  knowing  of  that  poison  which  he  did  nourish  in  his  own  body  and 


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intrals.  But  when  the  mother  considered  and  perceived,  that  her  childe  did  not  prosper 
or  profit  by  the  nourishment,  hut  continually  cried  and  wexed  wayward,  desired  me  to 
tell  her  the  cause  of  that  disease,  neither  was  it  any  hard  matter  to  doe,  for  his  body 
was  full  of  the  small-pocks,  whelkes,  and  venerous  pustules:  and  the  brests  of  the  nurses 
and  mother  being  looked  on,  were  eroded  with  virulent  ulcers  ;  and  the  body  of  the  father 
and  his  two  sonnes,  the  one  about  three  yeares,  and  the  other  foure  yeares  of  age,  were 
infected  with  the  like  pustules  and  swellings  that  the  childe  had;  therefore  I  shewed 
them  that  they  were  infected  with  the  Lues  Verenea,  whose  beginnings,  and  as  it  were 
provocations,  were  spred  abroad  by  the  nurse  that  was  hired,  by  her  maligne  infection. 
I  cured  them  all,  and  by  the  helne  of  God,  brought  them  to  health,  except  the  sucking 
childe,  which  died  in  the  cure  ;  and  the  nurse  being  called  before  the  magistrates,  was 
punished  in  prison  and  whipped  closely,  and  had  been  publikely  whipped  through  all  the 
streets  of  the  citie,  if  it  h^d  not  been  for  the  honors  of  that  unfortunate  family,”  Thus 
we  see  children  infected  by  filthy  nurses,  and  sometimes  nurses  be  infected  by  giving 
sucke  to  such  infected  children.  And  now  to  returne  to  my  former  purpose,  the  disease, 
as  saith  Nicholas  Masa,  whose  conn  cell  and  direction  in  the  cure  of  this  disease  I  have 
greatly  observed.  The  disease  because  it  hath  a  flowing  matter,  being  once  entered  into 
any  part  of  the  body,  proceedeth  on  from  part  to  part,  never  resting  until  it  hath  cor¬ 
rupted  the  liver,  with  the  ill  disposition  of  this  infection  especially.  When  it  touclieth 
any  such  part,  as  hath  in  it  an  apt  disposition  to  admit  such  infection,  as  when  the  action 
or  force  of  the  agent  is  wrought  and  imprinted  in  the  patient,  fitly  atfected  to  receive 
the  same  forme,  and  so  it  disperseth  itselfe  through  the  whole  bodie:  likewise  this  sick- 
nesse  is  many  times  bred  in  the  mouth,  by  eating  and  drinking  with  infected  persons,  and 
sometimes  onely  by  breathings  ;  and  Almanor  a  learned  pliysition  setteth  dowuefor  truth, 
that  this  disease  may  be  taken  by  kissing,  and  sometimes  by  lying  in  the  bed  with  them, 
or  by  lying  in  the  sheets  after  them  ;  also  it  is  said  to  come  by  sitting  on  the  same  stoole 
of  easement,  where  some  infected  person  frequenteth,  and  sometimes  such  as  have  been 
cured  of  this  disease,  fall  into  it  againe  by  wearing  their  old  infected  apparell:  all  which 
causes  of  this  disease  I  rather  set  downe,  for  that  I  would  thereby  admonish  as  many,  as 
shall  read  this  treatise,  to  be  carefull  of  themselves  in  this  belialfe,  and  to  shun  as  much 
as  may  be,  all  such  as  may  be,  all  such  occasions. — A  Profitable  and  Necessarie  Booke  of 
Observations  for  all  those  that  are  burned  with  the  flame  of  gun-powder,  etc,  By  William 
Clowes,  London;  M.  Dawson,  1637.  pp.  151-2-3. 

Gideon  Harvey,  in  liis  “Venus  Unmasked,”  published  two  hundred  years 
ago,  expresses  similar  views  : 

4.  Proibl.  How  many  various  ways  the  pox  exert  its  contagion  ?  No  external  part  is 
impowered  to  transmit  its  infection  immediately,  except  where  it’s  suscepted  ;  so  we  ob¬ 
serve  the  venereal  parts  to  be  infectory  immediately  upon  the  susception  of  virulency, 
but  not  through  kissing,  sucking  of  the  breast,  by  sweat,  or  through  any  other  parts  but 
themselves.  So  the  mouth  that’s  infectod  by  kissing,  or  sucking  a  thorow  pockified 
whore’s  tet,  is  capable  of  immediately  infecting  another’s  lips  by  kissing,  or  any  other  part 
by  sucking  it,  because  the  pocky  miasms  are  neer  ;  but  not  by  copulation,  or  sweat,  etc., 
because  the  contagion  cannot  be  crept  so  far.  Experience  verifies  this  dictate,  Is  it  not 
an  ordinary  trick  of  wenchers  (as  Musa  relates)  to  suck  whore’s  tongues,  andtets  of  their 
breast  and  yet  those  whom  they  know  have  been  pockified  many  years  about  their  lower 
parts,  and  for  that  reason  though  their  appetites  are  furious,  yet  dare  not  be  dabbling, 
but  the  other  they  reiterate  a  thousand  t  imes  over  without  the  least  hazzard  ?  An 
instance  for  the  other  part  of  the  dictate,  which  I  had  from  my  first  master  in  physick, 
that  wonder  of  physicians,  Prof.  Job.  Antonid,  vander  Linden,  p.  m.,  the  profoundest  com¬ 
mentator  on  Hippocrates  and  Celsns  that  ever  any  age  presented,  whom  I  heard  that  most 
famous  Professor  liegius  Guido  Patin  intitulate  the  Dutch  Hippocrates.  He  during  his 
luculent  practice  at  Amsterdam ,  had  a  merchant’s  prentice  in  cure  of  an  genorrlie,  and  a 
blistered,  or  cankered  like  mouth  ;  both  symptoms  he  contest  to  have  started  upon  him  at 
the  same  time.  The  excellent  Professor  being  curious  and  admiring  at  the  rarity  of  such 
distant  symptoms  emerging  at  once,  extorted  an  ingenuous  confession  from  his  patient, 
upon  pretence  that  it  would  facilitate  and  abreviato  the  cure  :  the  other  without  any 
longer  suspense  impudently  told  him  his  tongue  was  as  unfortunate  as  his  tayl  ;  a  sort  of 
diabolick  satyrisrn,  outvying  Aretius  flagello  de  Principi  and  very  like  a  Dutch  invention. 
What  insued?  this  bastard  at  a  Besoeck  (an  invitation  that’s  usually  made  to  young  folks, 
preliminary  to  all  weddings)  accosted  himself  to  two  pretty  damsels,  and  being  planted 
between  them,  oft  flanckt  to  the  right,  and  in  a  kiss  pledged  his  right  hand  man,  and  so 
to  the  left,  and  performed  the  like  duty  there.  But  the  tragick  event  may  imprint  a  dread 
upon  all  young  women.  A  short  time  after  their  lips  felt  hot,  inflamed,  grew  sore  and 
ulcered,  one  named  it  the  thrush,  another  a  sore  mouth  ;  vulgar  applications  rather  pro¬ 
moted  than  checkt  the  evil,  wherein  they  persisted  so  long  that  accessory  accidents,  as 
sordid  ulcers  of  the  palat  and  tonsils,  nocturnal  pains,  etc.,  moved  a  jealousie  of  the  fowl 
disease.  Here  you  may  remark,  how  innocently  the  poor  lasses  pessundated  their 
fortunes.  The  reflexion  of  this  relation  upon  the  latter  part  of  the  dictate  I  commit  to 
your  own  thoughts. 


Spurious  Vaccination:  Joseph  Jones ,  M.  D. 


365 


2.  A  wench  or  monsieur  by  that  time  they  are  thorow  pockified,  are  infectious  in  any 
part  where  ever  the  pox  bursts  out,  because  the  virulent  seminaries  are  propagated  quite 
through  the  body,  which  exhaling  at  the  places  affected,  transport  the  contagion.  What 
the  thorow-pox  is  expect  below  ;  so  that  when  the  malady  is  tumefyed  to  so  high  a  flood, 
its  time  for  nurses,  physicians,  anti  all  visitors  to  stand  off;  upon  suqji  occasions  a  person 
may  be  infected  by  drinking  out  of  the  same  vessel  (provided  the  spittle  adhering  be  warm 
still),  as  we  have  heard  of  many  ;  {Leonardos  Botallus  adduceth  an  observation  of  a  patient 
of  his,  of  a  chast  and  religions  converse,  who  was  stigmatized  by  a  peculiar  pledging  of 
his  familiar,  then  under  a  sore  affliction  of  thorow-pox.  His  lips  inflamed,  afterwards 
ulcered,  his  jaw  bone  grew  carious,  and  was  miserably  rackt  with  nocturnal  arlhritick, 
pains).  By  trying  of  a  warm  pocky  glove  ;  by  succeeding  a  virulent  patient  on  a  close 
stool  ;  by  shifting  of  him,  or  making  his  bed  whilst  tke  sheets  continue  warm  ;  as  Nicol. 
Massa’s  friend  and  patient,  who  incurred  this  evil,  by  touching  the  sheets,  one  lay  in, 
that  was  lame  of  a,  Neapolitan  ulcer  in  his  legg  ;  and  that  old  woman  in  Horst’s  observ. 
aged  fifty-six,  tending  a  pocky  fellow  in  his  lying  in,  was  seized  of  the  same  disease  in  as 
furious  a  degree  as  her  master :  and  by  kissing,  witness  Faventinus,  who  knew  a  young 
man,  that  contracted  this  evil  by  oft  kissing  a  fowl  slut.  The  initial  symptoms  appeared 
about  his  mouth  ;  his  privities,  which  otherwise  might  have  bin  suspected,  appearing 
free  from  all  contagion.  To  this  IT  parallel  another;  one  Mrs.  &c.,  then  a  pocky  inhabi¬ 
tant  of  the  Hague,  having  run  the  gantlop  of  several  cures,  hydrotick  and  mercurial,  at 
last  proved  with  child;  her  reckoning  being  expired,  she  was  brought  to  bed  of  a 
monster,  in  all  particulars  resembling  a  living  child  ;  saving  the  skin,  which  was  abomi- 
nally  ciphered  with  spots  and  botches,  This  object  of  mercy  upon  us  was  committed  to 
the  care  of  a  nurse,  the  infant  aspiring  to  higher  things,  had  bade  world  adieu.  But  the 
unhappy  nurse  had  cause  to  curse  her  late  foster  child,  her  breasts  and  head  ulcered,  a 
caries  got  into  the  cranium,  the  pox  took  possession  of  the  poor  woman’s  carcase,  for  want 
of  a  purse  to  release  her.  The  pocky  original  Mistris,  &c.,  was  proclaimed  barbarous  by 
a  whole  jury  of  matrons,  for  refusing  relief  to  the  disastered  woman.  In  all  these  trans¬ 
actions  the  Hater  FamiUas  stood  it  out  vigorously  with  a  fresh  countenance,  no  sign  con¬ 
tradicting  his  pancratick  health.  Just  such  another  mischance  Musa  Brasavous  tells  us, 
befell  a  nurse  that  suckled  one  Sr.  Orolo’s  child,  tliorowly  conspurcated  with  the  pox. 
The  observation  hereupon  infers  this  a  thorow-pox,  and  consequently  must  prove  infec¬ 
tions  in  all  parts  of  the  body.  Physicans  in  this  case  run  a  great  risk  iu  feeling  pulses  and 
approaching  such  patients  in  their  sweats. — Venus  Unmasked,  or  a  More  Exact  Discovery 
of  the  Venereal  Evil,  or  French  Disease  :  By  Gideon  Harvev,  London  ;  T.  Grismond,  1665, 
pp  94-5-6-7-8-9. 

In  like  maimer  Daniel  Turner  in  liis  work  on  syphilis,  published  in  1717, 
maintains  the  contagious  nature  of  constitutional  syphilis  : 

And  this  I  intend  shall  suffice  for  its  chronology  or  time,  the  topology  or  place,  and  the 
Mstriography  or  account  of  the  disease  in  general;  which,  with  some  other  writers  there¬ 
on,  we  shall  now  define,  a  venomous  or  contagions  distemper,  for  the  most  contracted  by  im¬ 
pure  coition,  at  least  some  connect  of  the  genitels  of  both  sexes,  or  some  other  lowed  and  filthy 
dalliance  between  each  other  that  way  tending. 

1  said  for  the  most  part,  because  it  is  beyond  controversy,  the  infection  is  communicated 
by  other  ways,  as  from  pocky  parents  by  inheritance  ;  by  sucking  an  infected  nurse,  to 
the  child;  suckling  a  diseased  child,  to  the  nurse;  lying  also  in  bed  with  the  diseased, 
without  aiTy  carnal  familiarity  ;  by  which,  though  it  may  be  possible  for  strong  and  vig¬ 
orous  bodies  to  escape,  yet  are  the  tender  ones,  especially  of  little  infants,  very  likely  to 
be  contaminated,  as  I  have  more  reason  to  believe  than  by  bare  imagination. 

There  are  several  other  more  uncommon  ways  of  giving  as  well  as  receiving  the  vener¬ 
eal  venom  ;  some  of  which  I  have  already  imparted  to  the  world  in  short  remarks  upon  a 
quack  libel,  printed  several  years  past.  But  the  thought  of  such  vile ' monsters,  and 
their  execrable  practices,  is  too  shocking  (unless  to  the  dregs  of  human  nature)  to  bear 
a  repetition  of  circumstances,  and  fit  only  for  a  detestable  gonologium  or  collection  of  smutt 
and  obscenity,  in  which  I  am  told,  they  have  been  inserted,  as  some  of  the  author’s  own 
observations. 

As  for  those  fancied  ways  of  catching  it  by  common  conversation,  drinking  after  one, 
sitting  on  the  same  close-stool,  drawing  on  a  glove,  wiping  on  the  napkin  or  towel,  after 
the  infected  person,  with  a  hundred  the  like  stories,  I  believe  in  our  time  (whatever  may 
have  happened  formerly)  there  is  no  great  danger.  Yet  we  find  in  one  of  our  late  chron¬ 
icles,  that  these  and  such  like  imaginations  were  so  strongly  riveted  in  men’s  minds  at 
that  time,  even  those  of  the  better  and  more  learned  sort,  that  it  was  one  of  the  articles 
against  a  noted  cardinal  that  he  had  breathed  on  the  king,  when  he,  the  said  cardinal, 
iiad  this  disease  upon  him,  which  you  will  find  in  Baker’s  Chronicle,  and  of  which  pas¬ 
sage  Dr.  Harvey  has  also  taken  notice. 

Hildanus  likewise  tells  us  of  a  young  gentlewoman,  who  contracted  the  same,  by  only 
putting  on  the  apparel  of  a  geutlemau  (that  it  Seems  was »pox’d)  at  a  masquerade,  of 
wuich,  through  modesty  concealing  her  illuoss  (which  first  of  ail  had  seized  the  Pudenda) 


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till  she  was  past  recovery,  she  deceased.  The  good  man’s  credulity,  at  least  his  charity, 
might  however  be  abus’d  in  this  relation,  as  the  young  lady  perhaps  was  also  after  the 
masque,  otherwise  than  by  simply  putting  on  the  habit.  But  were  it  so  as  the  case  is 
stated,  there  is  nothing  thei’ein  much  more  admirable  than  what  the  same  great  man  re¬ 
cites  of  a  whole  family  he  knew  infected,  viz:  the  wife* with  three  children  and  a  fourth 
in  the  womb,  as  also  a  maid  servant,  by  the  husband,  who  had  got  the  distemper  in  their 
absence  only  by  sleeping  in  the  same  bed  with  his  man  servant,  whom  he  after  under 
stood  was  broke  out  with  this  distemper. 

The  relation  of  Horst  and  Hornung  are  yet  more  strange,  of  several  people  infected  in 
the  bagnio,  by  having  the  same  scarificator  apply’d  after  cupping,  as  had  been  used  to  a 
venereal  patient,  which  seems  alike  credible  with  that  of  the  priest  poxed  at  his  ear,  in  the 
time  of  confessing  a  wanton  nun ;  the  venomous  breath  from  her  mouth  defiling  the  holy 
father.  But  enough  of  this. — Syphilis ;  A  Prartical  Dissertation  outlie  Venereal  Dis¬ 
eases  By  Daniel  Turner,  London  :  R.  Bonwicke  &  Co.,  1717,  pp.  10,  11,  12. 

John  Hunter,  in  his  u  Treatise  on  the  Venereal  Disease,”  gives  a  number 
of  instances  of  the  communication  of  secondary  syphilis,  from  which  we 
select  the  following: 

A  lady  was  delivered  of  a  child  on  the  thirtieth  of  September,  1776.  The  infant  being 
weakly,  and  the  quantity  of  milk  in  the  mother’s  breasts  abundant,  it  was  judged  proper 
to  procure  the  child  of  a  person  in  the  neighborhood  to  assist  in  keeping  the  breasts  in  a 
proper  state.  It  is  worthy  of  remark  that  the  lady  kept  her  own  child  to  the  right  breast, 
the  stranger  to  the  left.  In  about  six  weeks  the  nipple  of  the  left  breast  began  to  inflame, 
and  the  glands  of  the  axilla  to  swell.  A  few  days  after  several  small  ulcers  were  formed 
about  the  nipple,  which,  spreading  rapidly,  soon  communicated  and  became  one  ulcer, 
and  at  last  the  Avliole  nipple  was  destroyed.  The  tumor  in  the  axilla  subsided,  and  the 
ulcer  in  the  breast  healed  in  about  three  months  from  its  first  appearance.  On  inquiry, 
about  this  time,  the  child  of  the  stranger  was  found  to  be  short-breathed,  had  the  thrush, 
and  died  tabid,  with  many  sores  on  different  parts  of  the  body.  The  patient  now  com¬ 
plained  of  shooting  pains  In  different  parts  of  the  body,  which  were  succeeded  by  an 
eruption  on  the  arms,  legs  and  thigh,  many  of  which  became  ulcers. 

She  was  now  put  under  a  mercurial  course,  with  a  decoction  of  sarsaparilla.  Mercury 
was  tried  in  a  variety  of  forms :  in  solution,  in  pills  internally,  and  externally  in  the  form 
of  ointment.  It  could  uot  be  continued  above  a  few  days  at  a  time,  as  it  always  brought 
on  fever  or  purging,  with  extreme  pain  in  the  bowels.  In  this  state  she  remained  fill 
March  16,  1779,  when  she  was  delivered  of  another  child  in  a  diseased  state.  The  child 
was  committed  to  the  care  of  a  wet  nurse,  and  lived  about  nine  weeks;  the  cuticle  peel¬ 
ing  off  in  various  parts,  and  a  scabby  eruption  covering  the  whole  body.  The  child  died. 

Soon  after  the  death  of  the  child,  the  nurse  complained  of  headache  and  sore  throat, 
together  with  ulceration  of  the  breasts.  Various  remedies  were  given  to  her,  but  she 
determined  to  go  into  a  public  hospital,  where  she  was  salivated,  and  after  some  months 
she  was  discharged,  but  not  cured  of  the  disease.  The  bones  of  the  nose  and  palate  ex¬ 
foliated,  and  in  a  few  months  she  also  died  tabid. 

Of  the  various  remedies  tried  by  the  lady  herself,  none  succeeded  so  well  as  sea-bath¬ 
ing.  About  the  end  of  May  she  began  a  course  of  the  Lisbon  diet-drink,  and  continued 
it  with  regularity  about  a  month,  dressing  the  sores  with  laudanum,  by  which  treatment 
the  sores  healed  up  ;  and  in  September  she  was  delivered  of  another  child,  free  from  ex¬ 
ternal  marks  of  disease,  but  very  sickly,  and  it  died  in  the  course  of  the  mouth. 

About  twmlve  months  after  the  sores  broke  out  again,  and,  although  mercurial  dress¬ 
ings  and  internal  medicines  were  given,  remained  for  a  twelve-month,  wrhen  they  began 
again  to  heal  up.  „  *  *  *  *  * 

The  third  case  was  of  a  gentleman,  where  the  transplanted  tooth  remained,  without 
giving  the  least  disturbance,  for  about  a  month,  when  the  edge  of  the  gum  began  to 
ulcerate,  and  the  ulceration  went  on  until  the  tooth  dropped  out,  Some  time  after  spots 
appeared  almost  everywhere  on  the  skin  ;  they  had  not  the  truly  venereal  appearance, 
but  were  redder  or  more  transparent,  and  more  circumscribed.  He  also  had  a  tendency 
to  a  hectic  fever,  such  as  restlessness,  want  of  sleep,  loss  of  appetite  and  headache. 
After  trying  several  things,  and  not  finding  relief,  he  was  put  under  a  course  of  mercury, 
and  all  disease  disappeared  according  to  the  common  course  of  the  cure  of  the  venereal 
disease,  and  we  thought  him  well ;  but  some  time  after  the  same  appearances  returned, 
with  the  addition  of  swelling  in  the  bones  of  the  metacarpus.  He  was  now  put  under 
another  course  of  mercury,  more  severe  than  the  former,  and  in  the  usual  time  all  the 
symptoms  again  disappeared.  Several  months  after  the  same  eruption  came  out  again, 
but  in  not  so  great  a  degree  as  before,  and  without  any  other  attendant  symptoms.  He 
a  third  time  took  mercury,  but  it  was  only  ten  grains  of  corrosive  sublimate  in  the  whole, 
and  he  got  quite  well,  The  time  between  his  first  taking  mercury  and  his  being  cured 
was  a  space  of  three  years.— The  Works  of  John  Hunter,  with  Notes,  edited  by  James 
F.  Palmer.  Vol,  2,  pp.  470,  476,  484. 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


367 


In  an  extract  from  a  letter  to  Dr.  Duncan,  published  in  the  u  Medical 
Commentaries  for  the  years  1783-84-85,”  it  is  said  that  a  new  disease  lias 
lately  been  discovered  in  London,  occasioned  by  the  transplanting  of  teeth 
from  the  head  of  one  person  to  that  of  another.  The  mortality  from  it  is 
computed  at  nearly  two  deaths  to  ten  diseases ;  and  about  one  in  every 
hundred  who  receive  teeth  by  transplantation  are  affected  with  the  disease. 
Ulcerations  of  the  throat  and  gums,  and  eruptions  on  the  skin,  are  the 
chief  marks  of  the  disease.  When  death  takes  place  it  is  from  the  occur¬ 
rence  of  sphacelus.  For  five  or  six  w6eks  after  transplanting,  the  teeth 
look  well,  and  are  as  firm  as  the  others.  Pp.  490-491. 

In  the  third  volume  of  the  London  Medical  Transactions,  Dr.  William 
Watson,  Vice  President  of  thelloyal  Society,  recorded  an  interesting  case, 
illustrating  the  terrible  effects  of  transplanting  teeth,  from  which  we  ex¬ 
tract  the  following  particulars : 

An  unmarried  lady,  in  the  twenty-first  year,  of  her  age,  of  a  delicate 
habit,  but  in  other  respects  in  perfect  health,  observing  one  of  the  incisors 
of  her  upper  jaw  to  become  black  and  carious,  determined  on.  having  it 
replaced  by  a  sound  tooth.  This  was  accordingly  done  by  an  able  dentist; 
the  tooth  which  was  introduced  being  taken  from  the  mouth  of  a  person 
apparently  healthy  in  every  particular.  At  the  end  of  a  mouth,  her  mouth, 
which  had  continued  all  that  time  a  little  tender,  became  very  painful.  Her 
upper  gums  were  at  first  inflamed  and  enlarged ;  afterwards  they  were 
discolored  and  ulcerated.  This  ulceration  spread  very  fast,  insomuch  that 
the  gums  of  the  upper  jaw  were  corroded  away,  and  the  alveoli  left  bare. 
Before  another  month  was  at  an  end,  the  ulceration  occupied  the  whole 
space  under  the  upper  lip  between  the  teeth  and  nose ;  it  extended  likewise 
to  the  cheeks  and  throat,  which  were  corroded  by  large,  deep  and  fetid 
ulcers.  Soon  alter  this,  part  of  the  alveoli  of  the  upper  jaw  became  carious, 
one  of  her  teeth  dropped  out;  and  in  a  few  days  a  second  tooth,  together 
with  the  transplanted  tooth,  which  hitherto  had  remained  firm  in  its  place. 
About  this  time  blotches  appeared  on  her  face,  neck  and  various  parts  of 
her  body ;  and  several  of  these  became  ulcerated  sores.  The  fetid  dis¬ 
charges  from  her  mouth  and  throat  had  for  a  considerable  time  deprived 
her  of  sleep ;  and  the  soreness  of  the  parts  had  prevented  her  from  takiug 
nourishment.  And,  in  addition  to  these,  the  soreness  from  the  external 
ulcers  induced  such  a  degree  of  fever  that  her  death  was  soon  expected. 

When  Dr.  W atson  was  consulted,  concluding  that  all  her  fluids  were  in 
a  most  putrid  and  acrimonious  state,  he  directed  peruvian  bark  combined 
with  gum-myrrh  in  large  doses.  Ho  benefit  resulted  trom  this  plan,  and 
the  patient  was  placed  upon  alterative  doses  of  mercury.  The  improvement 
was  marked,  the  ulceration  was  arrested  and  the  blotches  began  to  dis¬ 
appear.  The  internal  administration  of  mercury  was  abandoned,  on  ac¬ 
count  of  its  irritant  effect  upon  the  bowels,  and  the  impression  was  kept 
up  by  rubbing  mercurial  ointment  into  her  legs  and  thighs  ;  this  practice 
in  like  manner  was  attended  with  beneficial  effects.  In  about  ten  or  twelve 
days,  the  blotches  had  entirely  disappeared  and  the  ulcers  of  the  mouth 
almost  completely  healed.  The  griping  and  purging,  however,  returned 
with  such  violence  that  Dr.  Watson  was  compelled  to  abandon  the  mercury 
altogether.  Small  portions  of  the  carious  alveoli  continued  to  exfoliate, 
the  ulceration  began  again  to  spread,  the  patient  labored  under  great  weak¬ 
ness,  with  frequent  returns  of  feverish  heat,  and  was  every  night  oppressed 
with  colliquative  sweats.  Her  strength  gradually  lessened,  till  death  put 
an  end  to  her  sufferings. 

As  the  progress  of  the  disease  was  not  impeded  by  the  most  powerful 
antiseptics  in  liberal  doses,  and  as  it  gave  way  to  mercurials  even  in  small 


368 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


doses,  there  appeared  to  be  good  ground  for  believing  that  the  taint  was 
truly  venereal;  but  Dr.  Watson,  although  aware  of  the  great  subtility 
ot  the  venereal  poison,  was  perplexed  by  the  statement  that  the  person 
from  whom  the  tooth  was  taken  was  perfectly  well,  and  never  had  any 
venereal  taint. 

Mr.  Clement  Hamerton,  Surgeon  to  the  Castletown  Dispensary,  has  re¬ 
corded  in  the  Dublin  Journal  (March,  1841)  cases  illustrating  the  introduc¬ 
tion  of  syphilis  into  the  system,  through  other  channels  than  sexual  inter¬ 
course,  trom  which  he  draws  the  following  conclusions  : 

•A  healthy  child  is  applied  to  the  breast  of  a  venereal  nurse ;  in  a  couple 
of  weeks  syphilis  shows  itself  in  the  child.  A  venereal  child  is  applied  to 
the  breast  of  a  healthy  woman ;  soon  afterwards  she  gets  a  syphilitic  sore 
of  the  breast,  .which  contaminates  her  system.  A  servant  girl  sucks  a 
venereal  sore  breast,  she  gets  a  venereal  ulcer  of  the  mouth,  which  taints 
her  system.  The  midwife  has  a  slight  scratch  on  the  palm  of  the  hand,  and 
in  delivering  a  putrid  venereal  child,  she  gets  a  sore  on  the  hand  which  in¬ 
fects  her  system  ;  and  lastly  the  husband  of  the  widwjfe  is  diseased  at  the 
time  the  ulcer  exists  upon  his  Avife’s  hand. 

Dr.  Egan  has  recorded  (Dublin  Quarterly  Journal,  May,  1846)  seA7eral 
cases  illustrating  the  contagiousness  ot  secondary  syphilis.  In  the  first 
case  the  child  was  born  apparently  healthy;  eight  weeks  afterward  syphi¬ 
lis  appeared.  An  ulcer  then  presented  itself  upon  the  breast  of  the  nurse, 
and  secondary  syphilis  occurred.  In  the  second  case  the  child  was  born 
apparently  healthy ;  about  ten  weeks  afterward  a  suspicious  rash  appeared, 
succeeded  by  blisters  and  fissures  about  the  mouth  ;  ulcers  occurred  on  the 
nurse’s  breasts,  and  then  a  scaly  eruption  and  other  secondary  symptoms. 
Both  cases  were  cured  by  anti-syphilitics.  In  the  third  case  the  Avoman 
was  a  dry  nurse,  being  disqualified  by  age  from  suckling.  The  child  was 
unhealthy,  and  affected  with  sores,  of  a  brownish  color,  about  the  nates 
and  mouth,  and  a  constant  floAv  of  saliva.  A  scratch  appeared  on  the  neck 
of  the  nurse,  whether  produced  by  a  pin  or  torn  by  the  nails  of  the  child 
was  uncertain ;  but  being  in  the  habit  of  bringing  the  child’s  mouth  in 
contact  with  the  affected  part,  in  order  to  induce  sleep,  the  disease  was  be¬ 
lieved  to  be  communicated  through  the  abrasion,  and  the  local  effect  was 
succeeded  by  an  eruption,  cured  by  anti-syphilitics. 

In  a  trial  which  took  place  at  Cork,  Dr.  O’Connor  and  Dr.  Bull  gaA7e  evi¬ 
dence  to  show  that  a  child  affected  with  syphilitic  eruption  may  convey 
the  contagion  to  the  nurse.  (Lancet,  July  4, 1846.) 

Dr.  Hector  Gavin  has  given  the  history  of  a  case  where  a  man.  and  his 
wife,  purporting  never  to  have  had  syphilis,  had  a  first  child  born  perfectly 
free  from  any  traces  of  the  disease,  subsequently  to  Avhich  the  diseased 
child  of  a  woman  known  to  have  had  syphilis,  but  supposed  to  be  cured, 
was  placed  to  the  wife’s  breast,  the  nipple  being  “  cracked”  at  the  time, 
and  the  disease  was  communicated.  (Lancet,  July  18,  1846 — Bankin’s 
Abstract.) 

Mr.  Price,  of  Margate,  has  recorded  the  case  of  a  woman  who  had  syph¬ 
ilis,  which  commenced  in  the  nipple,  from  nursing  an  infected  child.  She 
gave  birth  to  one  child  affected  with  the  disease,  and  to  another  dead  child. 
The  child  from  whom  this  woman  derived  the  disease  had  a  very  sore  month 
and  smelt  very  badly,  and  its  father  was  knoAvn  to  have  secondary  syphilis 
of  an  aggravated  character.  Another  respectable  married  woman,  six 
weeks  afterwards,  applied  to  Mr.  Price,  having  syphilis,  with  a  large  sore 
on  one  of  the  nipples,  and  it  turned  out  that  this  woman  was  nursing  the 
same  child  which  had  affected  the  former  nurse.  This  woman’s  oavii  child 
also  had  the  disease.  This  woman  affected  her  husband.  Two  years  and 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


369 


fire  months  subsequently  she  gave  birth  to  another  child  ;  this  was  affected 
with  syphilis ;  twelve  months  subsequently  another  child  was  born  simi¬ 
larly  affected,  and  after  this  the  mother  was  cured  with  iodide  of  potas¬ 
sium.  Several  very  remarkable  cases  by  Lallemand,  Dr.  King  and  Dr. 
Maenick,  will  also  be  found  in  the  twelfth  volume  of  the  Medical  Times — 
pp.  81,  176,  422 — Rankin’s  Abstract,  v.  10,  p.  336. 

According  to  M.  Rizzi,  who  had  an  ample  field  for  recording  tacts  relat¬ 
ing  to  congenital  syphilis,  in  a  large  hospital  under  his  charge  in  the  city 
of  Milan,  it  a  woman  contracts  specific  ulcerations  on  the  breast  by  suck¬ 
ling  an  infected  infant,  mucous  tubucles  very  frequently  develop  them¬ 
selves  on  the  vulva  and  about  the  anus;  and  the  syphilis,  although  second¬ 
ary,  is  transmissible  by  contact,  so  that  a  perfectly  innocent  woman  may 
communicate  the  disease  to  her  husband ;  and  it  behooves  the  medical  at¬ 
tendant  to  be  well  apprised  of  this  fact,  as  upon  his  knowledge  of  it  not 
only  the  health,  but  the  peace  of  mind  and  honor  of  the  individuals  must 
rest. 

Of  one  hundred  individuals  with  chancres  on  the  breast  from  impure  lac¬ 
tation,  or  on  the  mouth  or  throat,  derived  from  contact  with  an  infected 
infant,  thirty-four  have  tubercles  of  the  vulva,  nineteen  syphilitic  angina, 
three  iritis,  fourteen  tubercles  of  the  vulva  and  angina  simultaneously,  five 
tubercles  of  the  vulva,  and  others  disseminated  over  other  parts  of  the 
body  of  divers  complicated  symptoms,  six  tubercles  of  the  vulva,  angina, 
tubercles  on  the  skin  and  iritis,  and  nineteen  no  secondary  symptoms. 

In  nurses,  as  well  as  in  men  infected  with  them,  M.  Rizzi  has  remarked 
that  tubercles  are  the  most  common  form  of  secondary  symptoms,  and 
angina  is  frequently  superadded.  A  discharge,  vegetations,  and  exostoses, 
are  very  rare,  and  buboes,  when  they  occur,  consist  only  of  swelling  and 
tension  of  the  sub-maxillary  or  axillary  glands. 

In  fifty-three  infants,  the  disease  manifested  itself  one  month  after  birth 
in  thirty -three  ;  at  the  expiration  of  two  months  in  eleven  ;  of  three  months 
in  four ;  and  in  one  only  after  the  expiration  of  eight  months.  These 
statistics  show  how  easily  parties  may  be  deceived  as  to  the  condition  of 
infants  that  have  been  subject  to  the  syphilitic  poison,  from  infants  taken 
by  them  to  nurse,  without  the  slightest  apprehension,  whose  parents  even 
might  not  have  a  suspicion  of  the  existence  of  the  disease. — Rankin’s 
Abstract,  vol.  v.  p.  219,  from  Gaz.  Med.  di  Milano,  and  Gaz.  Med.  de  Paris, 
Oct.  25,  1846). 

On  the  twenty-fifth  of  October,  1858,  a  letter  was  addressed  to  the  Im¬ 
perial  Academy  of  Medicine  at  Paris,  by  the  Minister  of  Commerce,  Agri¬ 
culture  and  Public  Works,  requesting  an  authoritative  answer  upon  two 
question;  first,  whether  constitutirnal  syphilis  was  contagious;  and 
secondly,  whether,  as  regards  contagion,  there  was  a  difference  between 
constitutional  syphilis  as  seen  in  infants  at  the  breast  and  in  adults.  This 
letter  led  to  the  appointment  of  a  commission  consisting  of  MM.  Velpeau, 
Ricord,  Devergie,  Depaul,  and  Gilbert,  and  these  commissioners  reported 
and  their  report  was  adopted  by  the  Academy, — first,  that  some  of  the 
manifestations  of  secondary  syphilis,  especially  condylomata,  are  undoubt¬ 
edly  contagious;  and  secondly,  that  there  is  no  reason  to  suppose  that  the 
case  is  different  in  infants  at  the  bi  east  and  in  adults. 

The  commissioners  arrived  at  this  conclusion  after  examining  the  clinical 
facts  and  experimental  researches  already  on  record,  and  after  four  experi¬ 
ments  of  their  own,  which  was  taken  with  great  reluctance  on  their  part. 
The  persons  experimented  upon  were  all  suffering  from  lupus,  but  free 
from  any  syphilitic  taint,  and  these  were  chosen  from  the  notion  that  the 
treatment  for  syphilis,  if  the  inoculation  took  effect,  might  possibly  be  of 
service  in  remedying  the  lupus. 


370 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


The  following  case  will  serve  as  an  example  of  the  four  experiments: 

On  a  man  whose  face  had  been  affected  with  lupus  from  childhood,  a  raw 
surface  was  made  on  the  left  arm  by  strong  ammonia,  and  to  this  was  ap¬ 
plied  a  piece  of  lint  soaked  in  purulent  matter  obtained  from  a  condyloma 
near  the  anus  of  a  person  who  had  had  a  chancre  fifteen  months  previously. 
The  condyloma  was  of  fifteen  days  standing.  Fourteen  days  afterwards 
there  was  slight  redness  at  the  seat  of  inoculation.  Four  days  later  still,  a 
prominent  coppery-colored  papule  made  its  appearance  in  the  same  part. 
On  the  twenty-second  day  this  papule  was  much  larger,  and  there  was  a 
slight  oozing  from  the  surface.  During  the  week  following,  the  oozing, 
after  being  purulent,  dried  up  into  a  thin  scab.  On  the  twenty-ninth  day 
a  gland  in  the  corresponding  axilla  became  enlarged.  Ou  the  fifty-fifth  day, 
the  papule  on  the  arm  had  become  a  real  tubercle,  with  some  slight  ulcera¬ 
tion  in  the  centre,  and  several  blotches  and  coppery  papules  had  made  their 
appearance  on  the  trunk.  During  the  week  following,  these  papules  became 
multiplied  on  the  body,  and  they  spread  also  to  the  extremities ;  many  of 
them  also  changed  into  pustles  of  acne.  Two  or  three  days  later  the  pa 
tient  was  put  under  the  treatment  for  syphilis,  and  in  six  weeks,  at  the  date 
of  the  report,  there  was  still  much  to  be  done  in  the  way  of  a  cure. 

In  addition  to  asserting  the  contagiousness  of  secondary  syphilis,  the 
commission  arrived  at  the  conclusion  that  there  are  characteristic  grounds 
of  distinction  between  the  primary  and  secondary  affection,  and  that  the 
period  of  incubation  in  the  secondary  affection  is  from  eighteen  to  twenty 
days,  or  even  longer :  and  that  the  result  is  first  a  papule,  and  then  a  tuber¬ 
cle,  which  is  finally  converted  into  an  ulcer  covered  with  a  crust. — Rankin’s 
Abstract,  No.  30,  p.  272,  from  Comptes  Rendus,  May  24  and  31,  1849. 

We  might  greatly  multiply  such  facts  from  various  authors,  but  this  ap¬ 
pears  to  be  unnecessary,  as  the  experience  of  the  authors  just  quoted  covers 
three  centuries;  and  we  are  justified  in  affirming  that  it  is  nqw  clearly 
established  that,  constitutional  syphilis  can  be  transmitted  by  direct  inocu¬ 
lation  with  the  secretions  of  secondary  sores. 

And  recent  experiments  have  shown  that  the  blood  of  persons  affected 
with  constitutional  syphilis  is  capable  when  inoculated  on  healthy  subjects 
of  giving  rise  to  syphilitic  disease. 

Waller  succeeded  in  inoculating  a  healthy  boy  fifteen  years  old,  with  this 
disease,  by  applying  the  blood  of  an  individual  affected  with  secondary 
syphilis  to  incisions  made  by  a  scarificator  on  the  body  of  the  boy.  Well 
marked  and  unmistakable  symptoms  of  secondary  syphilis  followed  this 
experiment. 

In  Gibert’s  case,  the  blood  was  taken  from  a  large  squamous  papule  on 
the  forehead.  “The  point  of  the  lancet  was  thrust  into  the  circumference 
of  the  papule,  and  charged  with  a  blood  which  was  somewhat  serous.”  It  may 
be  objected  that  the  blood  in  this  experiment  was  mixed  with  some  of  the 
diseased  secretions  within  the  papule  itself. 

The  secretary  of  the  Society  of  Medicine  of  the  Palatinate  communicated 
the  general  results  of  the  inoculations  performed  by  an  individual.  “Of 
those  men  inoculated  with  the  same  blood,  three  were  successful,  and  there 
were  cases  where  a  large  absorbing  surface  had  been  rubbed.” — Archives 
G6nerale,  secs.  10, 11,  p.  603. 

Whatever  objections  may  have  been  urged  to  these  experiments,  no 
fault  can  be  found  with  the  well-conducted  experiments  performed  by  Prof. 
Pelizzari,*  of  Italy,  in  1862. 

As  this  subject  is  of  great  interest,  we  present  the  account  of  these  ex¬ 
periments  : 


♦Lectures  ou  Syphilis,  by  Henry  Lee,  1863 ;  p.  198. 


Spurious  Vaccination :  Joseph  Jones,  M.  D. 


371 


This  physician  inoculated  two  medical  students  with  the  blood  of  a  syphilitic  patient 
with  a  negative  result.  On  the  sixth  of  February,  1862,  he  resumed  his  experiments, 
three  physicians,  Drs.  Bargioni,  Rosi,  and  Passagli  submitting  themselves  to  his  investi¬ 
gations.  The  blood  of  a  female  patient,  aged  tweuty-five,  affected  with  constitutional 
syphilis,  and  who  had  undergone  no  treatment,  was  used  for  the  purpose.  The  blood 
was  drawn,  with  a  new  lancet,  from  the  cephalic  vein.  The  patient  was  at  the  time 
affected  with  mucous  papules  on  the  left  labium,  at  the  place  where  the  chancre  had  ex¬ 
isted  ;  mucous  tubercles  surrounded  the  anus,  and  the  inguinal  glands  were  indurated 
and  enlarged,  and  there  were  pustules  on  the  head.  At  the  point  on  the  arm  from  which 
the  blood  was  drawn  there  was  no  sign  of  any  eruption,  the  skm  of  the  part  was  well 
washed,  and  the  surgeon  washed  his  own  hands.  The  bandage  was  new,  as  was  also 
the  vessel  in  which  the  blood  was  recei  ved. .  As  the  blood  escaped  from  the  cephalic  vein, 
some  of  it  was  received  on  a  piece  of  lint,  which  was  placed  on  the  upper  part  of  Dr. 
Bargioni’s  arm,  where  the  epidermis  had  previously  been  removed,  and  three  tranverse 
incisions  made.  A  similar  operation  was  performed  on  the  other  two  gentlemen,  but  in 
the  case  of  one  the  blood  was  cold,  and  in  that  of  the  other  it  had  coagulated. 

After  twenty-four  hours  the  dressings  were  removed,  and  nothing  was  observed  but 
the  crusts  formed  by  the  effused  blood.  Four  days  afterwards  all  traces  of  the  inocula¬ 
tions  had  disappeared. 

On  the  morning. of  the  third  of  March,  Dr.  Bargioni  informed  Prof.  Pelizzari  that  in 
the  center  of  the  inoculated  surface  he  had  noticed  a  slight  elevation,  which  produced  a 
little  itching.  The  arm  was  examined,  and  at  the  point  indicated  Prof.  Pelizzari  found  a 
small  papule  of  a  roundish  form,  and  of  a  dull-red  color.  On  the  eighth  day  the  papule 
had  augmented  to  the  size  of  a  twenty-centime  piece.  On  the  eleventh  day  it  was  cov¬ 
ered  with  a  very  thin  adherent  scale,  which  became  denser,  and  on  the  second  day  com¬ 
menced  to  crack  in  its  central  part.  On  the  fourteenth  day  two  axillary  glands  became 
enlarged  to  the  size  of  nuts.  The  papule  remained  indolent,  and  there  was  no  induration 
at  its  base.  On  the  twenty-first,  the  scale  was  transferred  into  a  true  crust,  and  the 
part  beneath  was  ulcerating.  Slight  induration  was  more  evident.  On  the  twenty-sec¬ 
ond  the  crust  was  detached,  leaving  a  funnel-shaped  ulcer,  with  elastic  and  resistant 
borders,  forming  an  annular  induration.  There  was  but  a  small  amount  of  secretion  from 
the  sore,  and  the  pain  was  trifling.  On  the  twenty-sixth  the  ulcer  had  become  as  large 
as  a  fifty-centime  piece,  and  the  surrounding  induration  was  considerably  increased.  Up 
to  the  fourth  of  April  the  ulcer  remained  stationary,  but  at  that  date  its  base  appeared 
to  be  granulating.  The  axillary  glands  remained  swollen,  hard,  and  indolent.  Slight 
noctural  pains  occurred  in  the  head  about  this  time,  and  the  posterior  cervical  glands 
became  somewhat  enlarged.  On  the  twelfth  of  April  spots  of  an  irregular  form  and  of 
rose  color  appeared  on  the  surface  of  the  body.  The  eruption  extended  itself,  and  dur¬ 
ing  the  succeeding  days  became  more  confluent.  No  constitutional  disturbance,  heat  of 
skin,  or  pruritus  accompanied  it.  On  the  twentieth  the  cervical  glands  had  increased  in 
size  and  were  harder.  The  chancre  mantained  its  specific  character  and  exhibited  no 
tendency  to  cicatrization.  On  the  twenty-second  the  color  of  the  eruption  was  decidedly 
coppery.  Small  lenticular  papules  were  now  perceived  to  be  mixed  with  the  erythema. 
The  edges  of  the  chancre  had  begun  to  granulate.  Mercury  was  now  administered. 

This  case  isjof  itself  sufficient  to  prove  the  iuoculability  of  syphilis  through  the  blood  of 
an  infected  person. 

No  objection  can  be  urged  against  this  inoculation,  that  any  precaution 
against  a  fallacious  result  had  been  neglected. 

The  following  may  be  accepted  as  the  generally  received  doctrines  with 
reference  to  the  inoculation  of  syphilis  : 

1.  There  are  two  kinds  of  primary  venereal  sores,  namely :  The  simple 
contagious  ulcers  of  the  genitals  ;  the  u  soft”  or  “  chancroid w  ulcer;  and  the 
true  chancre — the  “  indurated  ”  or  u  Hunterian  n  chancre. 

The  soft  or  chancroid  ulcer  is  a  purely  local  disease,  accompanied  by  sup¬ 
purating  enlargement  of  the  lymphatic  glands  of  the  region  in  anatomical 
relation  to  the  seat  of  the  sore;  it  is  non-infecting,  the  general  constitution 
not  being  affected  or  infected  by  the  virus  which  produces  it. 

The  poison  of  soft  chancre  can  be  transferred  or  transplanted  by  conta¬ 
gion,  or  by  inoculation  from  one  part  of  the  body  to  another,  and  thus  the 
person  who  is  the  subject  of  it  may  come  to  exhibit  second  sores  of  a  simi¬ 
lar  character  on  more  parts  than  one;  it  is,  therefore,  said  to  be  auto- 
inoculable.  The  general  system  not  being  infected,  an  attack  of  the  pri¬ 
mary  disease  is  not  succeeded  at  any  future  time  by  general  symptoms  ; 
and  the  primary  attack  affords  no  immunity  against  a  future  contagion* 


372 


Spurious  Vaccination  :  Joseph  Jones,  M.  D. 


The  true  indurated  or  Hunterian  chancre,  although  at  first  apparently  a 
local  disease,  does  not  remain  long  a  purely  local  disease  ;  it  is  accompanied 
by  indolent,  non- suppurating  m ulti pie  enlargements  of  the  related  lymphatic 
glands,  and  its  virus  infects  or  contaminates  the  whole  system,  which  is 
thus  protected  against  a  second  miasm  of  the  primary  disease.  The  gen¬ 
eral  infection  of  the  system  exhibits  itself  in  various  ways,  or  by  certain 
general  symptoms,  called  secondary ,  or  tertiary ,  or  constitutional  syphilis. 

It  does  not  follow  necessarily  that  the  two  forms  of  venereal  ulcer  are 
due  to  two  specifically  different  kinds  of  virus. 

Thus  some  surgeons  of  eminence  hold  with  Dr.  Boeek,  of  Christiana, 
that  the  soft  chancre  is  produced  by  the  same  virus  as  the  indurated  chan¬ 
cre;  the  two  forms  arise  from  the  intensity  of  their  virus  being  different. 
Soft  chancres  are  held  to  be  the  product  of  the  most  energetic  virus,  which 
by  its  intensity  develops  in  its  circumference  an  inflammation  which  puts 
an  obstacle  in  the  way  of  absorption  ;  indurated  chancres  are  the  product 
of  a  virus  of  less  intensity,  which  does  not  develop  an  inflammation  suffi¬ 
ciently  strong  to  impede  absorption.  When  the  matter  is  very  intense  xve 
get  a  definite  soft  chancre  ;  if  it  is  of  little  intensity  we  get  a  definite  indu¬ 
rated  chancre.  It  is  with  matter  of  an  intensity  different  from  these  that 
we  obtain  intermediate  forms  of  chancre,  to  which,  with  all  our  experience, 
we  are  uncertain  whether  or  not  the  primary  affection  will  be  succeeded  by 
constitutional  syphilis. 

Syphilis,  in  its  manifestations  as  a  general  or  constitutional  disease,  has 
a  period  of  incubation,  short  sometimes,  but  at  other  times  prolonged.  Con¬ 
stitutional  symptoms  rarely  occur  before  the  third  week  following  the  ap¬ 
pearance  of  the  primary  symptoms,  and  more  rarely  still  after  the  sixth 
month.  The  interval  is  one  marked  by  no  characteristic  disturbance  of  the 
general  health.  The  infection  may  not  manifest  itself  until  some  disturb¬ 
ance  of  the  constitution  is  brought  about.  For  instance,  Bamburger,  of 
Wurzburg,  mentions  two  cases  where  secondary  manifestations  did  not  ap¬ 
pear  until  the  occurrence  of  small-pox.  In  like  manner,  vaccination  may 
cause  such  a  disturbance  in  the  system  infected  with  the  syphilitic  poison, 
as  to  excite  the  manifestation  of  secondary  or  constitutional  symptoms. 

2.  Constitute  nal  syphilis  is  transmissible  to  offspring;  it  is  an  hereditary 
disease ,  and  like  the  constitutional  malady  in  the  parent,  it  exhibits 
its  manifestations  generally  in  their  system.  The  symptoms  of  hereditary 
or  congenital  syphilis  are  secondary  and  constitutional  symptoms.  Hered¬ 
itary  syphilis  exhibits  itself  in  the  offspring  of  syphilitic  parents,  not  in  the 
primary  form  of  a  chancre,  but  in  some  of  its  secondary  constitutional 
forms. 

3.  Syphilis  is  contagious  and  inoculable,  both  in  its  primary  form  and  in 
its  secondary  or  constitutional  stage;  and  when  it  is  thus  transmitted  to 
the  healthy  it  always  appears  first  in  the  primary  form.  Hot  only  can  the 
disease  be  propagated  from  the  original  chancre,  and  from  the  syphilitic 
eruptions,  but  by  inoculations  as  shown  by  the  experiments  of  Wallaceinl835 
by  Vidal  in  1849,  by  Waller  in  1850,  and  by  Kincker  in  1852.  All  the  g 
observers  assert  that  where  the  inoculation  was  performed  with  the  morbid 
secretions  of  constitutional  syphilis,  the  result  was  a  primary  lesion,  having 
all  the  characters  of  an  infecting  chancre.  A  remarkable  character  of  these 
inoculations  was  the  period  of  incubation  of  the  disease ,  which  never  ap¬ 
peared  before  the  expiration  of  the  second  week,  but  in  general  not  till  after 
the  expiration  of  the  fourth  week. 

The  interval  between  the  introduction  of  the  virus  and  the  appearance  of 
the  local  disease,  was  much  longer  than  when  inoculation  was  practiced 
from  a  primary  gore.  The  first  alteration  was  always  observed  at  the  spot 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


373 


where  the  inoculation  had  been  practiced  ;  the  disease  produced  had  a  pro' 
gress  essentially  chronic ,  so  much  so  indeed,  that  the  local  affection  was  still 
present  when  the  generel  symptoms  appeared  if  not  subjected  to  treatment. 

The  general  symptoms  only  appeared  at  the  end  of  a  month,  and  often 
much  later,  after  the  first  manifestation  of  the  local  lesion. 

4.  Whether  syphilis  be  really  derived  from  a  primary ,  or  from  a  secondary 
affection,  the  disease  which  appears  upon  the  recipient  is  alicays  the  primary 
form  of  syphilis,  always  a  chancre,  or  the  induration  which  only  requires  the 
most  trifling  modification  to  become  a  sore. 

A  chancre  appears  at  the  place  where  the  matter  of  contagion  from  the  secon¬ 
dary  lesion  has  been  applied. 

The  imparted '■  disease  never  appears  first  in  the  form  of  a  constitutional  mal¬ 
ady,  at  the  due  time  secondary  symptoms  become  manifested. 

There  intervenes  an  incubation  of  about  three  iceelcs. 

This  is,  then  a  mark,  a  test  by  which  we  can  distinguish  between  an  im¬ 
parted  syphilis  and  one  which  is  merely  aroused  from  latency  in  an  individ¬ 
ual  already  tainted.  In  the  former  case,  the  first  thing  observed  is  a  chan¬ 
cre  ;  in  the  latter  there  occurs  no  chancre,  but  the  disease  appears  at  once 
in  its  secondary  or  constitutional  form. 

When  therefore  syphilis  occurs  after  vaccination,  first  in  one  of  its  consti¬ 
tutional  manifestations,  it  is  a  proof  that  it  was  not  imparted  by  contagion, 
but  is  the  result  of  an  inherent  constitutional  taint. 

5.  Syphilis  may  be  communicated  by  inoculation  of  the  blood  of  a  person, 
whose  constitution  is  infected  with  syphilis;  and  from  whatever  source, the 
disease  which  first  results  is  a  chancre,  the  primary  form  of  syphilis.* 


III.  COMMUNICATION  OF  SYPHILIS  BY  VACCINATION:  POST 

VACCINAL  SYPHILIS— VACCINO  SYPHILITIC  INOCULATION. 

III.  As  we  have  before  said,  in  the  third  section  of  this  inquiry,  the 
acceptance  without  reserve  cf  the  doctrine  of  John  Hunter,  expressing  the 
impossibility  of  the  coexistence  of  two  actions,  or  two  local  diseases,  or  two 
different  fevers,  in  the  same  part,  or  in  the  same  constitution,  at  one  and 
the  same  time,  would  necessarily  lead  to  the  denial  of  the  possibility  of 
transmitting  syphilis,  through  the  medium  of  the  matter  produced  by  a 
distinct  disease  as  cow-pox. 

What  are  called  pathological  laws,  are  nothing  more  than  expressions  of 
the  fixed  modes  in  which  the  phenomena  of  disease  are  manifested,  and 
they  conform  to  truth,  only  when  they  conform  to,  or  formulate,  the  estab¬ 
lished  course  of  nature.  It  is  evident  that  a  law  may  correctly  express  the 
relations  of  a  certain  class  of  facts  and  phenomena  without  necessarily 
embracing  other  facts  and  phenomena,  which  upon  a  superficial  view  are 
related  to  those  undoubtedly  embraced  by  the  law. 

Whilst  the  law  of  Hunter  may  express  the  relations  of  the  actions  of 
the  special  poisons  of  the  exanthemata  (and  we  have  shown  in  the  third 
section,  that  it  was  from  this  very  class  of  diseases,  that  the  law  was 
formulated),  it  does  not  at  all  necessarily  follow,  that  it  is  applicable  to  the 
actions  of  poisons  differing  wholly  in  their  nature,  mode  of  origin,  and 
pathological  processes. 

The  poison  of  syphilis,  after  its  introduction  into  the  system,  induces 
profound  alterations  in  the  blood,  and  in  the  processes  cf  secretion  and 
nutrition,  and,  in  fact,  produces  derangement  through  all  the  solids  and 


♦iSullarU.  on  VaooiuiAtiwi,  p  •  UtiS. 


374 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


fluids.  The  economy  under  the  action  of  constitutional  syphilis,  is  to  be 
looked  upon  as  entirely  deranged.  When,  therefore,  another  disease  is 
engrafted  upon  this  state,  the  product  of  that  diseased  action  must  par¬ 
take,  more  or  less,  of  the  diseased  condition  of  the  blood  and  tissues.  Does 
any  one  deny  this,  with  reference  to  the  products  of  inflammation  excited 
in  the  syphilitic  subject?  Where  is  there  sufficient  proof  to  show,  that 
syphilitic  blood  and  lymph,  furnishing  materials  for  the  elaboration  of  the 
vaccine  matter,  loses,  altogether  during  this  new  process,  its  contagious 
and  poisonous  properties  in  the  vaccine  vesicle  ?  Is  not  the  vaccine  vesicle 
but  the  manifestation  of  a  general  disease  affecting  the  entire  system,  just 
as  the  eruptive  skin  affection  of  syphilis  is  the  manifestation  of  a  disease 
pervading  the  entire  system?  In  addition  to  the  facts  recorded  in  this 
inquiry,  is  it  not  well  known  that  the  fetus  in  ultero  is  affected  by  the  vac¬ 
cination  of  the  mother?  And  it  is  probable,  though  experiments  are  as 
yet  wanting,  that  the  blood  of  one  suffering  with  the  vaccine  disease  may 
propagate  the  disease  by  inoculation. 

If  then  it  be  possible  to  produce  a  protective  vaccine  pustule  in  an  in¬ 
dividual  suffering  from  secondary  syphilis,  then  it  is  established  that  two 
local  and  two  constitutional  diseases  may  exist  at  the  same  time  and  in  the 
same  constitution,  and  the  law  of  Hunter  falls  to  the  ground,  as  far  as  the 
action  of  these  two  animal  poisons  is  concerned. 

If  the  law  of  Hunter  be  universally  applicable,  we  should  have  no  vac¬ 
cine  disease  produced  at  all,  upon  indi  viduals  suffering  with  constitutional 
syphilis. 

But  even  admitting  that  the  special  contagious  matter  of  cow-pox, 
formed  from  the  blood  of  one  suffering  with  constitutional  syphilis,  is  free 
from  the  poison  of  syphilis,  how  can  we  practically,  in  the  process  of  vac¬ 
cination,  separate  this  from  all  admixture  with  the  diseased  epithelial  cells, 
cellular  tissue,  and  syphilitic  products  of  the  skin  and  blood.  If  the  dried 
scab  be  used,  does  not  this  cover,  and  in  fact  has  it  not  been  formed  from 
a  circumscribed  portion  of  structure  which  had  been  originally  tainted 
with  syphilis,  and  are  not  its  borders  encrusted  and  mixed  up  with  the 
products  of  the  secondary  diseased  skin  ? 

The  truth  is,  that  we  have  much  yet  to  learn  about  the  phenomena  mani* 
fested  by  the  living  organism  when  acted  upon  simultaneously  by  two  or 
more  poisons.  Much  of  our  established  treatment  consists  in  the  use  of 
certain  poisons,  often  related  to  those  under  which  the  system  is  laboring. 

In  this  inquiry  we  do  not  need  pathological  formula  and  generalizations, 
so  much  as  well  authenticated  facts. 

We  cannot  subscribe  to  the  doctrine,  that  practically  all  danger  may  be 
avoided,  by  proper  caution,  as  “every  morbid  appearance  on  the  cutaneous 
envelope  has  its  own  peculiar  character,  by  which  it  may  be  distinguished 
from  other  similar  phenomena,  and  thus  the  observer  may  easily  establish 
a  distinction  between  the  vaccine  vesicle  and  other  vesicular,  bullar,  or  pus¬ 
tular  eruptions.”  Is  it  not  well  known  that  syphilis  may  lurk  for  years  in 
one  individual,  never  occasioning  so  much  inconvenience  as  to  arouse  sus¬ 
picion,  until  it  is  unmasked  by  the  unexpected  appearance  of  an  infected 
offspring?  On  the  other  hand  how  fearful  and  destructive  is  the  progress 
of  the  disease  in  others,  in  which  from  the  iirst  apperance  of  the  chancre, 
symptom  follows  symptom,  sore  throat,  swelled  testicle,  iritis,  eruptions, 
nodes,  ulcerations,  and  caries,  until  the  entire  body  has  become  apparently 
a  mass  of  nltli  and  rottenness. 

We  are  utterly  and  profoundly  ignorant  of  the  variations  of  the  vaccine 
vesicle  uuder  those  different  states  of  the  constitution  j  and  we  are  utterly 


Spurious  Vaccination:  Joseph  Jones ,  M.  D. 


375 


and  profoundly  ignorant  of  those  conditions  which  are  essential  to  the  trans¬ 
mission  of  the  syphilitic  poison  through  the  medium  of  the  vaccine  vesicle. 

But  to  the  facts  : 

About  twenty-nine  years  ago  a  medical  man  was  condemned  to  two  years 
imprisonment  tor  having  vaccinated  several  children  from  a  child  exhibit¬ 
ing  a  syphilitic  eruption  on  its  face  aud  body.  The  witnesses  asserted 
that  the  vaccine  pustules  had  not  been  properly  developed,  and  were  fol¬ 
lowed  by  tedious  ulcerations.  Moreover,  nine  grown-up  persons  were  asser¬ 
ted  to  have  been  re-infected  by  the  children  tainted  through  the  vaccine 
pustule. 

The  judgment  was  commuted,  in  consequence  of  the  opinions  expressed 
by  Messrs.  Heyfelder  and  Pauli,  two  distinguished  medical  men  of  Rhenish 
Bavaria,  whose  judgment  had  been  supported  by  that  of  Ricord  and  Culler  - 
ier,  who  utterly  denied  the  possibility  of  communicating  the  syphilitic 
poison  by  the  agency  of  vaccine  lymph. — (B.  and  F.  Med.  Chirurg.  Rev., 
Oct.,  1855,  from  Bull.  Gen.  de  Tlierap,  July,  1855). 

Dr.  Whitehead  has  made  the  following  statement  in  the  “Third  Report 
of  the  Clinical  Hospital,  of  Manchester,”  p.  52: 

11  The  occasional  presence  of  eruptions  on  the  skin  and  other  forms  of  disease,  as  an 
entailment  apparent  or  actual  of  vaccination  in  a  family  not  previously  subject  to  such 
affections,  undoubtedly  operates  in  the  minds  of  many  very  much  to  the  depreciation  of 
the  procedure  as  a  preventive  aud  healthful  measure;  and  certainly  in  not  a  few  in¬ 
stances  there  would  seem  to  be  just  and  sufficient  reason  for  such  prejudice.  But  the 
cause  of  this  is  not  to  be  found  in  the  vaccine  virus  in  its  pure  state  ;  it  is  due  to  a  mor¬ 
bid  material  superadded,  and  its  nature  peculiar  and  extraneous.  The  noxious  matter 
commonly  conveyed  by  vaccination  is  the  syphilitic  poison .  A  child  of  naturally  vigorous  con¬ 
stitution,  whose  blood  is  tainted  with  the  poison  of  syphilis,  may  retain  the  outward 
appearance  of  health  up  to  three,  six  or  twelve  mouths,  or  even  two  or  three  years  longer 
before  a  characteristic  outbreak  shows  itself.  The  parents  of  such  a  child  may  also  have 
the  semblance,  to  superficial  observation,  of  faultless  health,  although  still  possessing 
the  seeds  of  the  malady  in  a  degree  sufficient  for  its  transmission  to  their  offspring.  It  is 
from  such  sources  that  mischief  is  often  derived  and  disseminated,  by  vaccination,  and  other 
modes  of  implication  ;  and  it  is  true  that  the  efficacy  of  this  great  sanitary  measure  has 
been  in  many  instances  rendered  questionable.” 

Dr.  Whitehead  furnishes  a  table  of  sixty-three  cases  of  infantile  syphilis, 
treated  in  the  course  of  twenty-two  months  at  the  Clinical  Hospital,  of 
Manchester,  and  out  of  these  cases  he  attributes  no  less  than  fourteen,  or 
twenty  two  per  cent.,  to  vaccination. 

This  proportion  appears  to  be  almost  incredibly  large ;  and  the  state¬ 
ment  of  Dr.  Whitehead  is  singularly  at  variance  with  that  of  such  men  as 
Acton,  Erasmus,  Wilson,  Watson,  Jenner,  Simon,  De  Merie,  Henry,  Lee 
and  other  distinguished  surgeons  and  physicians. 

Another  case  is  recorded  by  Dr.  Whitehead  in  his  work,  “  On  the  trans¬ 
mission  from  parents  to  offspring  of  some  forms  of  disease,  and  the  morbid 
taints  and  tendencies,”  1851,  p.  17. 

Cerioli,  of  Lucca,  relates  two  instances  illustrating  the  transmission  of 
syphilis  by  vaccination.  In  one  forty-six  children  were  vaccinated  from 
an  apparently  healthy  child,  and  of  the  entire  number  only  six  escaped 
syphilitic  contagion;  in  the  other  several  children  received  syphilis  at  the 
period  of  vaccination  from  a  child  apparently  healthy ,  but  whose  father  was 
.syphilitic,  the  child  herself  presenting  what  were  believed  to  be  syphilitic 
symptoms  at  a  subsequent  period. 

Similar  cases  have  been  recorded  by  Hiibner.  Eight  children  vaccinated 
from  a  child  apparently  healthy,  but  as  subsequent  investigation  showed 
contaminated  by  its  mother  with  syphilis,  presented  ulcerations  at  the  vac¬ 
cine  punctures  and  manifested  constitutional  symptoms.  Five  other  chil¬ 
dren  vaccinated  at  the  same  time  from  the  same  child  escaped. 


376 


Spurious  Vaccination:  Jose/pli  Jones,  M.  D. 


M.  Viennois*  lias  collected  many  cases  of  the  transmission  of  syphilis  by 
vaccination,  and  lias  summed  up  his  conclusions  from  the  data  on  hand. 
From  his  observations  and  researches  it  would  appear  that  syphilis  cannot 
be  communicated  by  vaccine  virus  taken  from  a  subject  affected  with  the 
disease  uuless  a  portion  of  the  blood  of  the  individual  is  also  inoculated. 
Thus  he  says : 

“W  hen  the  vaccine  virus  of  a  syphilitic  subject,  pure  and  unmixed  with 
blood,  is  inoculated  on  a  healthy  individual,  a  simple  vaccine  pustule  is 
obtained,  without  any  near  or  remote  syphilitic  complications  being 
produced. 

“On  the  contrary,  if,  with  the  vaccine  virus  of  a  syphilitic  individual 
who  either  has  or  has  not  at  the  time  constitutional  accidents,  a  healthy 
person  is  vaccinated,  and  the  point  of  the  lancet  be  charged  with  a  little 
blood  at  the  same  time  as  with  the  vaccine  virus,  both  diseases  may  be 
transmitted  by  the  one  operation — the  vaccine  disease  with  the  vaccine 
virus,  and  syphilis  with  the  syphilitic  disease.’’ 

M.  Viennois  also  concludes  that  in  such  cases  the  vaccine  vesicle  is  de¬ 
veloped  first,  and  that  after  undergoing  its  incubatory  period  the  syphilitic 
ulcer,  with  all  the  characteristics  of  a  true  chancre  appears. 

The  following  are  the  conclusions  of  M.  Viennois. 

1.  Syphilis  has  in  many  instances  been  observed  to  follow  vaccination, 
ever  since  the  introduction  of  that  operation,  and  by  authors  worthy  of 
credit,  French,  English,  German,  Italian,  etc. 

2.  When  a  syphilitic  subject  is  vaccinated,  in  whom  the  disease  is  in  a 
latent  state,  syphilitic  symptoms  may  be  developed  by  the  vaccine  in¬ 
fluence ;  these  symptoms  often  consist  in  general  eruptions  of  a  papular, 
vesicular  character,  but  a  chancre  never  forms  at  the  seat  of  the  vaccinal 
puncture. 

3.  On  the  contrary,  if  a  healthy  subject  be  vaccinated  with  vaccine  virus 
taken  from  a  syphilitic  subject,  and  the  lancet  be  charged  at  the  same  time 
with  a  little  blood,  as  well  as  vaccine  matter,  the  two  diseases  maybe 
conveyed  by  the  same  puncture — the  vaccine  with  the  vaccine  matter,  and 
syphilis  with  the  syphilitic  blood. 

4.  In  these  cases,  of  which  a  number  are  on  record,  vaccination  is  first 
developed  because  its  period  of  incubation  is  shortest,  and  its  evolution 
more  rapid  than  that  of  syphilis.  The  latter  appears  subsequently,  and 
manifests  itself  by  its  characteristic  lesion  at  the  inoculated  spot. 

5.  The  initial  lesion,  then,  by  which  syphilis,  following  the  vaccinal  pus¬ 
tule,  manifests  itself,  is  an  indurated  ulcer,  with  adenitis ;  in  a  word,  all 
the  phenomena  of  primitive  syphilitic  chancre.  The  great  law  announced 
by  M  Rollet,  that  syphilis  always  commences  by  a  chancre,  even  when 
it  result  sfrom  secondary  symptoms,  or  even  from  syphilitic  blood,  is  thus 
fully  confirmed. 

6.  After  the  primary  chancre  is  developed  at  the  inoculated  spot,  and  in 
the  usual  period,  secondary  syphilis  occurs,  and  runs  the  usual  course,  as  if 
transmitted  in  any  other  way. 

7.  When  the  mixture  of  virus  does  not  take  place  accidentally,  but  is 
affected  intentionally,  (as  practiced  by  MM.  Spereno  and  Dannies,  by 
mixing  the  vaccine  matter  with  the  pus  of  chancre),  the  result  is  the  same ; 
one  virus  does  not  destroy  the  other,  but  each  runs  its  separate  course. . 

8.  The  vaccine  matter  thus  acts  as  a  simple  vehicle  for  the  virus  con¬ 
tained  in  the  syphilitic  blood,  which  it  divides  and  dilutes,  as  a  drop  of 
water  would  do,  without  at  all  modifying  its  properties  or  its  effects. 


*  De  lit  Transmission  de  la  aSj  pliilis  par  la  Vaccination.  Archiv.  Gen.  de  Med.,  Juin,  Juiliot,  et  Sep 
tembre,  1860. 


Spurious  Vaccination :  Joseph  Jones ,  AT.  I). 


377 


9.  It  is  important,  then,  never  to  take  the  vaccine  virus  from  a  suspected 
person,  or  from  an  infant  whose  parents  are  unknown  before  the  age  at 
which  hereditary  syphilis  usually  manifests  itself, 

10.  If  circumstances  make  this  last  necessary,  great  care  should  ba 
taken  to  collect  only  the  vaccine  matter,  free  from  blood  or  any  syphilitic 
humor. 

11 .  In  no  case  should  a  healthy  subject  be  vaccinated  with  matter  taken 
from  a  syphilitic  subject,  for  in  spite  of  all  precautions,  there  can  be  no 
certainty  as  to  the  purity  of  the  vaccine  matter. 

12.  These  precautions  are  the  more  important,  because,  with  the  matter 
from  one  syphilitic  subject  a  number  of  persons  may  be  vaccinated,  and 
syphilis  conveyed  to  many  (as  seen  by  Ceriale,  of  Cremona). 

13.  It  is  sufficient  to  point  out  these  precautions,  to  avoid  new  evils,  and 
to  remove  the  cavils  of  the  enemies  of  vaccination  ;  for  in  these  cases,  the 
propagation  of  syphilis  is  not  the  fault  of  vaccination,  but  of  the  vac¬ 
cinator. — -Graz.  Med.  de  Paris,  Jan.  26, 1861.  American  Journal  of  Medical 
Sciences,  April,  1861. 

These  views  of  M.  Viennois  have  received  the  most  ample  confirmation 
from  the  tragedy  which  occurred  at  Kivalta,  in  Italy,  by  which  forty-six 
children  and  twenty  nurses  had  syphilis  commuuicated  to  them  through 
vaccination,  and  of  which  several  of  the  children  died.  The  full  details 
of  this  remarkable  event  are  given  in  a  memoir  by  Dr.  Pacchiotti,*  of 
Turin. 

On  tlie  twenty-first  of  May,  1861,  Sig.  Cagiola  vaccinated  Giovanni  Cliiabrera  with 
lymph  contained  in  a  tube  sent  from  Acqui.  Tht  operation  was  performed  in  the  usual 
manner  and  with  a  perfectly  clean  lancet.  The  child  was  eleven  months  old,  and  in 
good  health  at  the  time.  Forty-six  other  children  were,  teu  days  subsequently,  vac¬ 
cinated  with  the  lymph  taken  from  the  vesicle  of  this  child  ;  and  ten  days  after  this, 
seventeen  children  were  vaccinated  with  lymph  taken  from  the  arm  of  Lugia  Manzone, 
one  of  the  forty- six  first  vaccinated. 

Of  these  sixty-three  children,  forty-six — thirty-nine  of  the  first  lot  aud  seven  of  the 
last — were  within  two  months  attacked  with  syphilis.  On  the  seventh  of  October  seven 
of.  them,  including  the  little  Manzone,  were  dead,  three  were  yet  in  danger  of  dying, 
fourteen  were  recovering  under  the  use  of  mercury  and  iodine,  and  one  was  well. 

A  medical  commission  was  now  appointed  to  inquire  into  all  the  circumstances  con¬ 
nected  with  this  fatal  event,  and  they  proceeded  to  the  execution  of  the  duty  assigned 
them. 

Twenty-three  children  were  examined  in  full  ;  the  others  were  not  so  accurately 
noticed,  as  their  parents  had  neglected  to  avail  themselves  of  medical  aid  in  time.  In 
the  forty-six  children  who  were  affected,  syphilis  appeared  at  periods  varying  from  ten 
days  to  two  months  after  vaccination,  the  average  time  being  twelve  days.  The  initia¬ 
tory  symptoms  were  variable.  Sometimes  just  as  the  vaccine  vesicle  had  healed,  it  be¬ 
came  surrounded  with  a  red,  livid,  and  copper-colored  areola,  and  ulcerated  again.  In 
other  instances  an  ulcer  would  form  on  the  cicatrix,  and  become  covered  with  a  scab, 
which  in  a  few  days  would  fall  off  to  make  room  for  another,  and  so  on.  In  others  the 
vaccine  vesicles  had  an  unhealthy  appearance  from  the  first,  and  were  accompanied  by  a 
general  eruption. 

The  principal  symptoms  observed  by  the  commission  were  mucous  tubercles  in  the 
vicinity  of  the  anus  and  on  the  genitals,  ulcerations  of  the  mucous  membrane  of  the  lips 
and  fauces,  engorgement  of  the  lymphatic  glands  in  the  groin  and  neck,  syphilitic  skin 
diseases,  alopecia,  deep  tubercles,  gummy  tumors,  etc. 

In  two  subsequent  papers,  Dr.  Pacchiotti*  continues  the  detail  of  his  investigations. 
On  the  eighth  of  February,  twenty  of  the  mothers  or  nurses  of  the  forty-six  children  had 
become  affected  wTith  symptoms  of  syphilis.  He  ascertained,  too,  from  a  revaccination 
of  five  of  the  children,  that  the  occurrence  of  syphilis  had  not  destroyed  the  efficacy  of 
the  first  vaccination.  But  he  also  discovered  the  source  of  the  infection.  It  appeared 
that  a  year  and  a.  half  previously  a  young  unmarried  woman  had  syphilis,  and  that  she 
was  syphilitic  at  the  time  Chiabrera  was  vaccinated.  The  woman  was  the  mother  of  a 
child  which  had  died  syphilitic  three  months  after  its  birth.  After  the  death  of  the 
child  she  was  in  the  habit  of  having  her  breasts  drawn  by  the  little  Chiabrera,  and  gave 


*  Sifilide  trasmissa  per  Mezzo  della  Vaccinazione  in  Kivalta,  presso  Acqui.  Gazetta  della  Associazone 
Med.,  Octobre20,  1861. 


378 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


him  the  clothes  which  her  own  child  had  wore.  Another  child  nursed  by  this  woman, 
but  who  was  not  vaccinated,  also  became  syphilitic,  and  this  child  infected  its  mother 
just  as  little  Chiabrera  did  his  mother.  It  is  therefore  shown  that  the  vaccine  virus  used 
on  Chiabrera  was  not  at  fault,  but  that  all  tne  other  forty-five  children  were  infected 
through  the  lymph  taken  from  his  arm.  It  is  also  shown  that  blood  was  on  the  lancet 
when  several  of  the  children  were  vaccinated. 

Dr.  Pacchiotti,  as  the  results  of  his  investigations  and  those  of  the  commission  gives 
the  following  rules  to  be  observed  in  vaccinating  : — 

2.  Inquire  into  the  state  of  the  parent’s  health. 

'  3.  Take. the  lymph  in  preference  from  those  children  who  havepassed  the  fourth  or  fifth 
month,  as  hereditary  syphilis  appears  in  general  before  that  time. 

4.  Do  not  use  lymph  taken  from  a  vesicle  which  has  passed  its  eighth  day,  because  on 
the  ninth  and  tenth  days  the  lymph  becomes  mixed  with  pus,  which  latter  may  be  of  an 
infectious  character. 

5.  In  taking  the  lymph,  avoid  hemorrhage,  as  there  is  less  danger  with  lymph  free  from 
blood. 

6.  Do  not  vaccinate  too  many  children  with  the  same  lymph. 

In  consequence  of  the  publication  of  the  details  of  the  lamentable  affair  at  Rivalta, 
Dr.  Marone  concluded  to  relate  the  particulars  of  a  similar  event  which  occurred  to  him, 
and  in  regard  to  which  he  had  thought  it  advisable  to  maintain  a  discreet  silence.  The 
particulars  are  given  with  sufficient  fullness  by  Mr.  Lee,  whose  excellent  work  I  have 
already  referred  to  se  veral  times. 

It  seems  that  in  November,  1856,  Dr.  Marone  obtained  some  vaccine  lymph,  with  which 
he  vaccinated  a  number  of  children  at  Lupara.  The  lymph  was  contained  in  glass  tubes, 
and  Dr  Marone  noticed  that  it  was  mixed  with  a  little  blood,  which  affected  its  trans¬ 
parency.  Of  the  number  of  children  vaccinated  with  this  lymph,  notes  were  preserved 
in  twenty-three  cases.  All  these  were  affected  with  syphilis,  and  the  disease  likewise 
manifested  itself  among  the  mothers,  nurses,  and  even  the  servants  who  were  brought  in 
contact  with  them.  The  symptoms  with  which  the  children  were  affected  consisted 
chiefly  of  a  syphilitic  character,  and  subsequently  of  mucous  tubercles  at  the  angles  of 
lips,  around  the  anus,  and  on  the  vulva.  The  post-cervical  and  inguinal  glands  were 
enlarged,  and  there  was  emaciation,  in  degree  varying  with  the  severity  of  the  syphilitic 
symptoms. 

Besides  these  cases,  eleven  nurses  of  the  number  who  suckled  these  children  gave  the 
disease  to  eleven  other  children  who  were  not  vaccinated. 

In  some  of  the  cases  the  syphilitic  phenomena  continued  till  April,  1859. 

Dr.  Marone  draws  the  following  conclusions  from  his  experience  : 

“That  the  syphilitic  virus  was  really  transmitted  in  the  above  recorded  cases  by  means 
of  vaccination. 

“That  the  children  vaccinated  suffered  first,  and  became  the  means  of  transmitting 
the  disease  to  others. 

“  That  the  lymph  used  for  the  purpose  of  vaccination  was  impure,  being  mixed  with 
blood,  and  that  the  result  shows  how  necessary  it  is  to  abstain  from  using  lymph  of  that 
description.” 

In  the  sad  tragedy  enacted  at  Rivalta,  a  child  named  Chiabrera  was  vac¬ 
cinated  j  from  him  another  child  named  Manzone  was  reyaccinated,  with 
forty-five  other  children.  Syphilis  was  conveyed  from  Chiabrera  to  thirty- 
nine  children,  and  communicated  to  his  mother.  The  same  disease  was 
conveyed  from  Manzone  to  seven  children  and  his  wet  nurse.  Both  vaccin- 
ifers  were  very  ill,  and  one  died  three  months  after  vaccination.  Twenty 
nurses  or  mothers  were  known  to  have  been  similarly  affected ;  in  three 
cases  the  same  disease  was  again  communicated  from  the  mothers  to  their 
husbands,  and  in  three  other  cases  the  disease  was  communicated  to  other 
healthy  children. 

The  annexed  diagram  furnishes  a  view  of  the  progress  of  this  terrible 
disease  previously  unknown  at  Rivalta,  a  village  containing  not  more  than 
two  thousand  inhabitants : 


L’Union  Medicate,  Fey.  SemeetAvril  3eme,  1862. 


Spurious  Vaccination  :  Joseph  Jones,  M.  D. 


379 


GENEALOGICAL  SCHEME  OF  THE  KI YALTA  SERIES  OF  VAC- 
CINO-SYPHILITIC  INOCULATIONS. 

Tube  of  lymph  from  Acqui. 


Giovanni  Chiabrera, 

First  syphilitic  vacciuifer ;  lymph  bloody. 
Communicated  the  disease  to 


Louisa  Menzone,  second 
vaccinifer,  commu¬ 
nicated  the  disease  to 


His  mother  infected 
by  contagion. 


His  wet  nurse 
by  contagion. 


To  seven  other  children 
by  Araccinat.ion. 


Thirty-nine  other  children 
vaccinated. 


Communicated 


the  disease  to 


Eighteen  other  mothers 
or  nurses  by  contagion. 


Three  other  children,  not  vaccinated, 
by  contagion. 


Three  husbands  from  their  wives  by 
contagion. 

A  series  of  cases  similar  to  those  which  occurred  at  Rivalta,  is  related  by 
Dr.  Marone  to  have  happened  at  Lupara,  Dr.  Marone  ascribed  the  cause 
of  the  inoculation  to  the  admixture  of  some  blood  with  the  vaccine  lymph. 


380 


Spurious  Vaccination:  Joseph  Jones,  M.  D. 


THE  LUPARA  SERIES  OF  VACCINO -SYPHILITIC  INOCULA¬ 
TIONS. 

This  series  occurred  in  1856,  but  was  kept  secret  until  the  Rival ta  series 
had  been  made  public,  and  the  subject  was  undergoing  discussion  in  medi¬ 
cal  circles. 

M.  Marone,  in  whose  practice  it  occurred,  and  who  published  his  account 
of  it  in  1862,  (Impraziale  de  Florence,  No.  5,  1862),  states  that  he  had  not 
dared  to  make  it  known  before,  partly  because  of  his  own  reputation,  and 
partly  because  he  feared  that  lie  should  injure  the  cause  of  vaccination. 

Prior  to  1856,  syphilis  had  not  been  observed  among  the  peasants  of 
Lupara. 

The  following  is  the  summary  furnished  M.  Depaul  (De  la  Syphilis  Vac¬ 
cinate,  etc.,  p.  108)  : 

u  M.  Marone  obtained  some  lymph  in  tubes  from  Campobasso  *,  it  was 
transparent,  but  tinged  with  blood.  A  large  number  of  infants  were 
vaccinated,  and  twenty-three  of  them  were  infected  with  syphilis.  He 
gives  the  names  and  ages,  which  last  varied  from  five  to  ten  months.  All 
the  children,  as  well  as  their  parents,  were  healthy  at  the  time  of  the  vac¬ 
cination.  The  vaccinal  eruption  proceeded  regularly  up  to  the  period  of 
desiccation  ;  but  then  the  dry  crust  began  to  soften  anew,  and  when  it  fell 
off  an  ulcer  with  indurated  base  was  found  to  occupy  its  seat.  In  other 
cases  the  dry  crust  remained  adherent  for  an  unusual  length  of  time,  and 
then  fell  off. 

At  the  expiration  of  a  few  days  the  cicatrix  reopened  and  a  sore  was 
produced,  having  all  the  characters  of  an  indurated  chancre,  and  lasted  a 
month  or  six  weeks.  In  all  the  subjects  indolent,  non-suppurating,  en¬ 
larged  glands  in  the  axilla  were  observed.  In  all  of  them  also,  toward  the 
middle  of  January,  the  general  symptoms  of  syphilis  appeared — roseola, 
papules,  pemphigus,  mucous  patches  on  the  lips,  mouth,  anus  and  genitals, 
with  inguinal  and  cervical  glands  engorged.  The  nurses  were  infected 
in  their  turn  with  indurated  chancres  on  the  breast;  and  at  a  latter  period, 
that  is,  after  five  or  eight  weeks,  they  had  also  general  symptoms,  roseola, 
psoriasis,  impetigo,  mucous  patches,  etc.  In  their  turn,  also,  the  mothers 
imparted  the  disease  to  the  fathers. 

M.  Marone  has  since  learned  that  the  vaccine  sent  from  Campobasso  had 
been  furnished  by  a  little  girl  who  died  some  time  after  vaccination  from 
an  eruptive  affection,  the  character  of  which,  however,  has  not  been  thor¬ 
oughly  determined* 

Filomena  Littorti,  one  of  the  twenty-three  infected,  served  for  new  vac¬ 
cinations.  Eleven  infants  were  contaminated.  First  they  had  the  charac¬ 
teristic  primary  affection,  and  then  the  consecutive  phenomena.  Mothers 
were  again  contaminated  and  they  infected  others.  The  disease  having- 
been  at  last  recognized,  a  specific  treatment  was  instituted  ;  but  neverthe¬ 
less  several  of  the  children  died.  Eleven  nurses,  infected  by  the  vacci¬ 
nated  children,  infected  in  their  turn  other  children  who  were  not  vacci¬ 
nated,  but  who  had  been  suckled  by  them.  Several  of  the  contaminated 
women,  too,  having  fallen  pregnant,  were  confined  either  prematurely  or  at 
full  term  of  children,  dead  or  living,  but  in  every  case  hearing  the  marks  of 
congenital  syphilis. 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


381 


GENEALOGICAL  SCHEME  OF  YACCINO  SYPHILITIC  INOCULA¬ 
TIONS— LUP  AKA  SERIES. 

Tube  of  lymph  taken  from  Campobasso,  bloody,  vaccinifer  syphilitic. 


Filomena  Littorti 
Vaccinated,  infected. 


Twenty-two  other  children 
Vaccinated,  infected. 


Nurses  and  mothers  infected  by  contagion. 


I 

I 

Eleven  children  vaccinated, 
infected. 

I 

I 

'  * 


Husbands  infected 
by  contagion. 


Eleven  Nurses  infected  by  contagion. 


Several  bore  children 
infected  with  syphilis. 


Nurse,  children 
infected  by  contagion. 


382 


Spurious  Vaccination :  Joseph  Jones ,  M.  ID. 


THE  BERGAME  OR  TORRE  DE  BUSI  SERIES  OF  VACCINO- 

SYPHILITIO  INOCULATIONS. 

This  series  was  reported  to  the  Conseil  de  Sante  of  Bergame,  in  1862,  by 
Hr.  Adelasio,  and  is  included  in  a  paper  read  to  the  Congress  of  Lyons  by 
M.  Yiennois.  (He  la  Syphilis  Vaccniale,  etc.,  p.  303.  Vaccination,  Ed¬ 
ward  Ballard,  p,  337.) 

In  the  autumn  of  1861,  M.  Quarenghi,  a  physician  at  Terre  de  Busi,  vac¬ 
cinated  Pierre  Ferrari  with  lymph  which  had  been  preserved  from  the  last 
season  six  months  previously.  The  pustules  were  well  developed,  and  pre¬ 
sented  all  their  normal  characteristics;  so  good  were  they  that  they  were 
selected  for  the  vaccination  of  the  following  season.  In  none  of  the  sub¬ 
jects  vaccinated  at  this  time  did  the  vaccination  produce  any  morbid  com¬ 
plications.  It  is  to  be  observed  that  Ferrari  died  a  year  afterwards,  it  is 
said,  of  severe  cough.  The  parents,  when  examined,  in  April,  1863,  were 
found  perfectly  healthy,  and  they  had  a  reputation  of  being  moral. 

On  May  8,  1862,  Girolama  Carenini,  born  of  parents  young  and  in  perfect 
health,  was  vaccinated  with  the  lymph  of  Ferrari,  preserved  in  tubes.  It 
does  not  appear  in  the  statement  that  other  children  were  vaccinated  with 
the  same  lymph.  It  is  stated  by  the  mother  of  the  children  who  were  vac¬ 
cinated  from  Girolama  that,  although  she  was  plump  and  of  a  good  color, 
they  noticed  here  and  there  upon  her  an  eruption  which,  by  the  description 
given,  was  something  like  chicken-pox.  The  pustules  from  which  the  lymph 
was  taken  were  fine,  and  the  operation  itself  was  performed  with  a  needle , 
without  any  blood  being  drawn.  When  the  child  was  examined  subse¬ 
quently,  five  natural  cicatrices  were  found,  and  there  was  nothing  observed 
upon  the  body  of  the  child.  The  parents  were  also  carefully  examined,  and 
no  traces  of  syphilitic  affection  was  found  upon  them.  All  that  they  would 
admit  was  that  the  child  had  got  an  eruption  from  exposure  to  the  sun. 

From  this  child,  Girolama,  six  other  children  were  vaccinated  on  the 
fifteenth  of  May  (eighth  day),  and  out  of  the  six,  five  were  infected  with 
syphilis;  but  the  vaccinator  could  not  recollect  whether  the  one  which 
escaped  infection  was  vaccinated  first  or  last.  In  the  case  of  the  five  in¬ 
fected,  it  is  stated  that  the  fall  of  the  crusts  was  delayed,  and  that  indur¬ 
ated  ulcers  replaced  them,  which  were  followed  by  secondary  symptoms, 
which  were  in  no  case  typical,  but  left  copper-colored  stains.  About  the 
same  time  mucous  patches  appeared,  and  the  mothers  and  nurses  were  in¬ 
fected,  and  imparted  the  disease  to  their  husbands.  The  disease  spread 
also  by  contagion  to  brothers,  sisters,  aunts  and  cousins. 

Altogether  there  is  a  record  of  twenty-three  persons  whom  these  children 
infected.  One  of  the  infected  children,  Joseph  Valsecchi,  aged  five 
months,  who  infected  altogether  five  other  persons,  was  selected  on  May 
23,  for  supplying  lymph  for  the  vaccination  of  five  other  children.  It  took 
upon  all.  In  four  of  the  five  the  healing  of  the  pustules  is  said  to  have 
been  rather  tardy,  and  there  was  some  alteration  in  the  form  of  the  cica¬ 
trices,  and  in  two,  there  had  occurred  a  cutaneous  eruption,  which  got  well 
of  itself  and  did  not  affect  the  general  health. 

One  of  these  five,  Charles  Perruchini,  served  for  the  vaccination  of 
three  more  children,  who  remained  perfectly  healthy,  only  one  of  them 
presenting  the  cicatrices  a  little  elevated  in  the  middle! 

These  cases  render  it  evident  that  the  two  viruses,  that  of  vaccinia  and 
that  of  syphilis,  at  the  same  spot,  may  both,  one  after  another  be  devel¬ 
oped  there. 


Spurious  Vaccinativn  :  Joseph  Jones ,  M.  D. 


383 


GENEALOGICAL  SCHEME  OF  YACCINO-SYPHILITIC  INOOU- 
TIONS— BERGAME  OR  TORRE  DE  BUSI  SERIES. 

Preserved  lymph,  from  previous  season. 

'  i 

Pierre  Ferrari  (healthy). 


Girolama  Carenini  (doubtfully  syphilitic). 


Joseph  Yalseechi 
vacciuated,  iufected. 


Four  other  children  vaccinated, 
infected. 


Other  children,  mothers  and  nurses 
infected  by  contagion „ 


Charles  Perruchini 
vaccinated  and  remained  healthy. 

I 

l 

t 

Three  other  children 
vaccinated  and 
remained  healthy. 


Husbands  and  children  infected 
by  contagion. 


M.  Adelasio  records  an  additional  instance  of  infection  that  happened  at 
Alme,  in  the  same  province  as  Bergame,  in  September,  1863  . 


Y  ACOIN  O-SYPHILITIC  INOCULATIONS— A  GRAY  SERIES. 

The  account  of  this  series  is  given  by  M.  De  Paul.  (Bulletin  de  PAca- 
demie  Imp.  de  Med.,  t.  32,  No.  9,  p.  201.) 

The  first  intimation  of  the  occurrence  was  received  by  M.  De  Paul  from 
Drs.  Closmadeno  and  Denis,  ot  Auray,  who  accompanied  M.  De  Paul  in 
his  visit  to  the  place  three  months  afterwards,  and  some  additional  facts 
were  obtained  by  a  member  of  the  Academy,  M.  De  Kergaradec.  It  appears 
that  a  mid  wife,  named  Madame  Franchise  Lemouel,  an  experienced  vac¬ 
cinator,  was  the  vaccinator  of  the  series.  She  received,  on  May  20,  1866, 
some  dry  lymph  from  the  Prefecture  at  Vannes,  with  which,  on  the  next 
day,  she  vaccinated  two  children,  in  excellent  health,  named  Mahe  and  De 
Norcy.  Mahe,  when  visited  by  M.  De  Paul,  in  August,  was  aged  fifteen 
months,  and  had  two  ordinary  cicatrices  on  the  right  arm  and  three  on  the 
left.  A  little  indolent  axillary  adenitis  existed  on  both  sides.  According 
to  the  account  given  by  the  family,  he  had  been  very  ill  during  the  five 
weeks  succeeding  the  vaccination,  and  the  pustules  had  suppurated  during 
seven  weeks.  At  the  time  of  the  visit,  however,  he  was  very  well  in  health, 
although  he  had  not  undergone  any  specific  treatment,  and  his  mother  had 
not  suffered  in  any  way. 

Jean  Maire  De  Norcy,  aged  ten  months,  had,  like  the  preceding  child, 
been  suckled  by  his  mother.  He  was  a  large  and  fat  child,  and  appeared 
in  good  health.  He  had  on  each  arm  two  normal  scars,  only  still  a  little 


384 


Spurious  Vaccination:  Joseph  Jones ,  M.  D. 


red.  He  also  had.  on  both  sides,  a  little  indolent  axillary  adenitis,  cervical 
adenitis,  but  no  eruption  or  other  affection  of  the  skin.  The  mother  had 
not  suffered  in  health ;  but,  according'  to  her  and  her  husband,  the  child 
had  been  very  ill  for  at  least  two  weeks  after  the  vaccination,  the  pustules 
suppurating  during  all  that  time.  An  eruption,  which  they  called 
“measles,”  had  appeared  three  weeks  after  vaccination. 

DeForcy  was  used  as  vaccinifer  on  the  eighth  day  for  the  vaccination  of 
Marie  Francoise  Rosnaro.  She  presented  on  August  20,  on  each  arm,  six 
cicatrices,  perfectly  normal  both  in  size  and  color :  no  trace  of  adenitis, 
cervical  or  axillary,  and  no  eruption  upon  the  skin.  In  a  word  this  child 
was  completely  healthy,  and  in  excellent  general  condition.  Her  mother, 
at  the  time  of  the  visit, was  in  bed  with  rheumatismal  pains, but  M.  DePaul 
could  find  nothing  suspicious  about  her,  and  her  nipples  were  free  from  dis¬ 
ease.  The  father  of  the  child  also  was  found  free  from  all  syphilitic  in¬ 
fection. 

This  child  Rosnaro,  was  selected  as  vaccinifer  for  the  next  batch  of  vac¬ 
cinations,  of  which  more  than  eighty  were  made  on  the  third,  fourth  and 
fifth  of  June.  A  list  of  forty-two  children  who  suffered  from  syphilis,  hav¬ 
ing  been  vaccinated  from  Rosnaro  is  given  by  M.  DePaul;  they  suffered  as 
usual,  from  primary  ulcers  at  the  seat  of  the  vesicles,  followed  by  various 
secondary  affections.  Two  of  them  were  used  as  vaccinifers,  and  their 
history  is  as  follows  : 

Boulaire,  a  girl  aged  seventeen  months,  when  seen  in  August,  had  fallen 
away  a  great  deal,  and  had  all  the  aspects  of  the  syphilitic cachixia.  There 
were  two  violet-colored  cicatrices  on  the  left  arm,  one  upon  a  very  manifestly 
indurated  base,  and  three  similar  on  the  other  arm;  indolent  axillary 
adenitis  on  both  sides,  a  little  posterior  cervical  adenitis  and  general  ro¬ 
seola.  The  other,  Anna  Andran,  aged  nineteen  months,  was  still  suckled 
by  her  mother.  There  were  three  cicatrices  of  a  violet  tiut,  and  reposing 
upon  a  somewhat  indurated  base  on  the  left  arm,  and  three  on  the  right ; 
axillary  indolent  adenitis  on  both  sides,  considerable  on  the  right;  axillary 
adenitis  on  both  sides,  considerable  on  the  right,  but  less  on  the  left ;  pos¬ 
terior  cervical  adenitis  and  general  roseola. 

From  these  children,  Boulaire  and  Andran,  a  large  number  of  vaccina¬ 
tions  were  done,  certainly  less,  however,  than  from  Rosnaro.  M.  Depaul, 
however,  only  succeeded  in  seeing  and  examining  seventeen  of  them,  and 
three  of  these  seem  to  have  had  nothing  amiss  with  them  after  the  vaccin- 
tion,  but  the  rest  exhibited  phenomena  similar  to  those  observed  in  Bou¬ 
laire  and  Andran. 


/Spurious  Vaccination :  Joseph  Jones ,  M.  J). 


385 


GENEALOGICAL  SCHEME  OF  VACCINO-SYPHILITIO  INOCULA¬ 
TIONS—  A  CRAY  SERIES. 

Dry  lymph  from  prefecture  at  Vanues 


Mah6  vaccinated,  De  Norcy  vaccinated, 

infected.  infected. 


Marie  F.  Rosnaro, 
remained  healthy. 


Bouiaire  vaccinated, 
infected. 


40  other  children 
vaccinated,  infected. 


Anna  Aud-ran 
vaccinated,  infected. 


17  other  children  at  least 
vaccinated,  infected. 

In  a  western  departmenkof  France  (Morbihan),  some  villages  have  been 
the  theatre  of  severe  syphilitic  symptoms  in  more  than  thirty  children, 
who  had  all  been  vaccinated  from  a  little  girl  with  six  punctures  on  each 
arm,  the  child  herself  having  been  operated  upon  from  another  who  had 
been  vaccinated  from  lymph  preserved  between  two  plates  of  glass  ob¬ 
tained  from  the  authorities.  This  misfortune  created  so  much  sensation, 
that  the  Academy  of  Medicine  of  Paris  sent  down  two  commissioners. 
Messrs.  Henry  Rogu  and  Depaul.  These  gentlemen  presented  their  report 
to  the  Academy,  and  this  important  document  ends  with  the  following 
considerations  : 

1.  Several  of  the  children  whom  we  have  examined  were  undoubtedly 
suffering  from  secondary  syphilis. 

2.  We  see  no  way  of  explaining  this  contamination  but  by  vaccination, 
and  we  are  confident  that  the  cases  we  have  seen  were  really  syphilis  en¬ 
gendered  by  vaccination. 

3.  As  to  the  origin  of  the  virus,  it  is  very  probable  that  the  poison  is 
traceable  to  the  lymph,  preserved  between  two  pieces  of  glass,  supplied  by 
the  authorities. 

As  primary  symptoms  were  also  observed  among  the  children  M.  Ricord 
begged  the  commissioners  to  insert  that  fact  in  their  report,  which  these 
gentlemen  agreed  to  do.  Here  we  unfortunately  have  again  repeated  the 
sad  occurrences  which  took  place  at  Rivalta  (Italy),  a  short  time  ago. — 
(Medical  News  and  Library,  1867 — from  London  Lancet,  December  15, 
1866.) 

The  experience  of  the  Confederate  surgeons,  establishing  the  possibility 
of  communicating  constitutional  syphilis  by  vaccination  ;  the  experiments 
of  Waller,  Pelpizzari  and  others,  establishing  the  possibility  of  communi¬ 
cating  secondary  syphilis  by  inoculation  of  the  blood  from  patients  suffer¬ 
ing  with  the  constitutional  symptoms  of  this  disease  into  healthy  indivi¬ 
duals  ;  the  cases  collected  by  M.  Viennois  illustrating  the  transmission  of 
syphilis  by  vaccination  5  and  the  unfortunate  tragedy  of  Rivalta  in  the 


38G 


Spurious  Vaccination  :  Joseph  Jones ,  M.  1). 


district  of  Piedmont,  Italy,  where  syphilis  was  previously  unknown,  (forty- 
six  children  ot  various  ages  being  simultaneously  attacked  with  well- 
marked  syphilis,  proceeding  in  all  cases  which  could  be  properly  examined 
from  the  action  of  vaccine  virus  which  produced  chancre  on  the  arms,  fol¬ 
lowed  by  buboes  in  the  axilla,  and  all  these  children  had  been  vaccinated 
directly  or  indirectly  from  a  single  child,  who  was  subsequently  proved  to 
have  contracted  syphilis  from  a  wet  nurse,  and  these  children  transmitted 
the  disease  to  a  number  of  women,  their  wet  nurses  and  mothers,  and  even 
to  children  who  played  and  nursed  with  them,  and  the  women  so  infected, 
in  turn  infected  their  husbands,  and  finally  the  disease  yielded  in  all  cases 
to  the  usual  remedies  for  syphilis);  these;  and  other  similar  facts,  as  the 
infection  of  the  infant  at  the  breast  with  secondary  syphilis,  and  the  com¬ 
munication  of  syphilis  from  the  infant  inheriting  the  disease  from  its 
mother  or  father,  to  a  healthy  nurse,  all  demonstrate  the  possibility  of 
transmitting  constitutional  syphilis  by  inoculation  of  syphilitic  blood,  or 
vaccine  virus,  from  patients  poisoned  with  syphilis ;  and  each  such  fact,  of 
itself  is  sufficient  to  overthrow  the  dogma,  that  “primary  syphilis  alone  is 
capable  of  being  inoculated,  and  that  secondary  affections  and  the  consti¬ 
tutional  disease  cannot  be  communicated  from  one  individual  to  another, 
by  any  such  means  as  vaccination,  or  the  direct  inoculation  of  syphilitic 
blood.” 

Mr.  Jonathan  Hutchinson,  narrates  no  less  then  four  series  of  cases  in 
which  syphilis  was  communicated  by  vaccination,  in  volumes  54  and  56  of 
the  Medico  Ohirurgical  Transactions.  Such  is  the  importance  of  this  sub¬ 
ject  that  we  reproduce  the  observations  of  this  distinguished  surgeon, 
together  with  the  report  of  the  committee. 


REPORT  ON  VACCINO  SYPHILIS,  BY  MR,  JONATHAN  HUTCH¬ 
INSON. 


INTRODUCTION. 

The  following  report  contains  the  narrative  of  two  separate  series  of  cases.  At  the 
time  of  my  first  report  (which  was  read  before  the  society  on  April  25)  only  one  of  these 
had  come  under  my  notice,  and  at  that  time  none  of  the  patients  in  it  had  passed  further 
than  the  primary  stage.  The  discussion  of  this  paper  was  adjourned  for  a  fortnight, 
and  during  this  interval  the  second  series  of  cases  had  been  brought  under  my  notice.  At 
the  adjourned  meeting  I  presented  a  report  upon  them,  with  also  some  further  particulars 
regarding  the  first.  A  second  appendix  was  presented  to  the  society  at  its  last  meeting 
(June  27),  bringing  the  narrative  of  both  series  up  to  that  date.  At  that  time  many  of 
the  subjects  of  the  second  series  had  presented  all  the  symptoms  of  constitutional  syphilis 
in  its  most  typical  form  of  evolution,  while  none  of  those  in  the  first  had  shown  any 
constitutional  phenomena  which  could  be  pronounced  beyond  dispute.  This  difference 
I  was  inclined  to  explain  by  reference  to  the  fact  that  all  in  the  first  series  had  taken 
mercury,  while  none  of  those  in  the  second  had  had  any  treatment.  That  this  sugges¬ 
tion  was  correct  has  since  been  proved  by  the  occurrence,  in  four  of  the  first  group,  of 
secondary  lesions  of  the  most  unmistakable  kind. 

At  the  request  of  the  Council,  I  have  remodelled  my  original  paper,  with  its  two  ap¬ 
pendices,  and  endeavored  to  bring  all  the  facts  of  both  series  into  a  continuous  narrative 
up  to  the  present  date.  As  regards  the  main  points,  the  cases  will,  I  believe,  be  found 
amply  sufficient,  but  I  am  well  aware  that  respecting  some  individual  ones  there  is  less 
detail  than  could  have  been  wished.  The  peculiar  conditions  under  which  the  inquiry 
has  been  conducted,  the  necessity  for  avoiding  any  steps  likely  to  excite  the  alarm  of  the 
patients,  and  other  circumstances  to  which  I  need  not  avert,  have  prevented  me  from 
keeping  all  the  cases  under  such  close  observation  as  might  for  some  purposes  have  been 
desirable. 


387 


Spurious  Vaccination :  Joseph  Jones ,  M.  I). 


FIRST  SERIES  OF  CASES. 

Synopsis. — Twelve  Persons,  mostly  Young  Adults,  Vaccinated 
FROM  A  HeALTHY-LoOKING  CHILD — SATISFACTORY  PROGRESS  OF 
the  Vaccination  in  All — Indurated  Chancres  on  the  Arms 
of  Ten  of  the  Vaccinated  in  the  Eighth  Week — Treatment 
by  Mercury  in  All — Rapid  Disappearance  of  the  Primary 
Sores — Constitutional  Symptoms  in  Four  of  the  Patients 
Five  Months  after  the  Vaccination — The  Vaccinifer  Show¬ 
ing  CONDYLOMATA  AT  THE  AGE  OF  SlX  MONTHS. 

These  patients  came  under  my  observation  in  the  seventh  week  after  vaccination.  The 
suspicions  of  the  vaccinator  had  been  excited  about  a  fortnight  earlier,  and  he  had  ap¬ 
plied  to  the  medical  officers  of  the  Privy  Council  on  the  subject.  It  was  on  the  advice 
of  Dr.  Seaton  that  I  was  requested  to  see  the  patients  and  investigate  the  matter.  It 
was  with  the  permission,  and,  indeed,  the  suggestion,  of  the  surgeon  in  whose  practice 
it  occurred  (the  father  of  the  vaccinator)  that  the  facts  were  made  known  to  the  pro¬ 
fession,  and  I  cannot  help  expressing  here  my  admiration  of  the  moral  courage  with 
which  this  gentleman  met  a  calamity  which  caused  him  the  keenest  distress,  and  of  the 
anxiety  which  he  displayed  that  the  fullest  use  should  be  made  of  it  for  the  public  good. 

On  February  7,  1871,  a  young  surgeon  in  the  neighborhood  of  London  applied  at  a 
public  vaccine  station  for  a  supply  of  lymph.  He  was  offered  a  healtliy-looking  infant 
of  four  months  old,  then  on  the  eighth  day,  and  with  five  good  vesicles.  As  he  wished 
to  vaccinate  a  considerable  number  of  persons  in  the  same  house,  he  preferred  to  borrow 
the  child  rather  than,  as  first  proposed,  to  charge  points,  and  an  arrangement  having 
bee  n  made  with  the  mother,  the  child  was  at  once  taken  to  a  private  house  where  eleven 
youn  g  adults  (shopmen  and  servants)  were  vaccinated  from  its  arm.  Four  only  of  the 
five  vesicles  were  used,  and  the  testimony,  both  of  the  operator  and  the  child’s  mother, 
is  that  more  than  one,  and  possibly  all,  of  them  bled  somewhat.  Finally,  a  tube  was 
charged,  and  with  the  lymph  thus  obtained,  which  is  reported  to  have  looked  quite 
clear,  two  persons,  a  father  and  son,  residing  in  another  house,  were  immediately  after¬ 
wards  vaccinated.  Thus  we  have  a  total  of  thirteen  persons  vaccinated.  In  all,  ex¬ 
cepting  one  doubtful  case,  the  vaccination  was  second  to  successful  performance  of  the 
same  in  childhood.  In  the  doubtful  case  both  arms  were  done  ;  in  all  the  others,  only 
one  arm.  In  all,  excepting  one  instance,  the  vaccination  took,  and  the  vesicles  are  be¬ 
lieved  to  have  gone  through  their  usual  stages.  The  patients  were  not  under  any  close 
medical  inspection  afterwards,  as  none  of  them  needed  it,  but  it  seems  certain  from  their 
testimony  that  at  the  end  of  three  weeks  in  all  cases  the  scabs  had  fallen  and  small  round 
cicatrices  alone  remained.  At  the  end  of  a  month,  or  from  a  month  to  five  weeks,  sev¬ 
eral  of  them  applied  for  advice  because  the  scars  were  again  becoming  sore,  and  at  the 
expiration  of  two  months  it  was  quite  certain  that  ten  out  of  the  twelve  had  indurated 
chancres  on  their  arms.  Many  of  them  had  more  than  one  chancre,  and  about  half  had 
enlarged  axillary  glands,  whilst  two  or  three  suffered  from  febrile  disturbance  witliroseo- 
lous  rash.  I  will  append  to  this  paper  some  brief  notes  of  each  of  the  cases,  but  it  will 
be  convenient  for  the  present  to  restrict  our  attention  to  the  general  facts  as  to  the 
group,  and  to  turn  next  to  the  vaccinifer. 

FACTS  AS  TO  THE  VACCINIFER. 

The  infant  had  been  seen  by  the  public  vaccinator,  whose  patient  she  was,  and  by  the 
surgeon  who  borrowed  her,  and  to  them,  to  her  own  mother,  and  to  those  who  were  vac¬ 
cinated  arm  to  arm  from  her,  she  bore  the  aspect  of  general  health.  She  was  remarkably 
well  grown,  not  in  the  least  fretful,  and  had  gone  through  the  stages  of  her  own  vaccin¬ 
ation  perfectly  well. 

On  April  5,  two  months  after  the  vaccination,  she  was  brought  to  my  house  for  exami¬ 
nation.  Her  mother  ridiculed  the  idea  that  she  ailed  anything.  My  attention  was, 
however,  at  once  attracted  to  a  slight  peculiarity  in  the  tint  of  her  skin  and  to  the  look 
of  her  face  ;  and  although  it  was  strougly  denied  that  she  had  ever  “snuffled,”  yet  when 
she  was  made  to  cry  I  noticed  a  nasal  twang  which  was  very  suspicious.  On  having  her 
stripped  not  a  single  spot  of  rash  could  be  seen  ou  the  skin,  but  on  inspecting  the 
buttocks  five ‘stnail  circular  condylomata  were  discovered  close  to  the  anus,  about  which 
there  could  not  be  the  slightest  doubt.  Her  mother  now  admitted  that  she  had  been 
aware  for  a  week  of  the  existence  of  these  sores,  and  had  consulted  a  chemist  about 
them,  who  had  attributed  them  to  teething.  She  said  they  had  not  been  present  more 
than  a  week,  and  repeated  her  assurance  that  the  infant  had  not  seemed  in  the  least  ill. 
I  could  not  find  in  the  mother  herself  any  indications  of  syphilitic  taint,  nor  obtain  any 


388 


Spurious  Vaccination :  Joseph  Jones ,  M.  I). 


history  of  suspicious  symptoms.  She  looked  pale  and  cachectic,  as  if  underfed.  Shehad 
been  married  about  eighteen  months,  and  this  was  her  first-born  child.  Her  husband  was 
a  Frenchman  and  one  of  the  Paris  National  Guard.  I  prescribed  for  the  child  some 
mercurial  ointment,  and  was  very  desirous  to  keep  it  regularly  under  observation,  but 
the  mother  would  not  bring  it.  A  fortnight  later  (on  April  19),  I  sought  it  out  at  home. 
The  child  theu  looked  more  ill  than  when  I  first  saw  it;  the  condylomata  were  in  the 
same  condition.  It  had  no  rash.  Its  head  was  enlarging,  and  its  mother  complained  that 
it  was  wasting  away.  She  had  not  used  the  ointment,  alleging  that  its  father  would  not 
allow  her  to  do  so.  I  was  never  able  to  see  the  father  of  the  child,  although  I  used 
every  endeavor;  he  was  evidently  unwilling  to  be  seen,  and  his  wife  positively  refused 
to  give  me  his  address. 

About  the  existence  of  constitutional  syphilis  in  the  infant  at  the  date  of  my  examina¬ 
tion  (two  months  after  the  vaccination)  there  could  not  be  any  doubt,  and  scarcely  any 
as  to  the  taint  having  been  an  inherited  one.  The  vaccination  spots  presented  perfectly 
healthy  scars,  and  there  was  not  the  slightest  reason  lor  thinking  that  the  disease  was 
introduced  into  the  child’s  system  at  the  time  of  its  vaccination.  Had  such  been  the 
case  it  is  almost  certain  that  it  would  now  present  symptoms  similar  to  those  in  the 
patients  vaccinated  from  it,  i.  e.,  primary  sores  on  the  arm.  There  could  be  only  a  week’s 
difference  in  the  stage  of  the  disease  in  itself  and  in  those  vaccinated  from  it.  Instead 
of  this  we  find  the  child  presenting  the  ordinary  symptoms  of  hereditary  syphilis, — 
condylomata,  commencing  marasmus,  and  hydrocephalus.  That  a  syphilitic  infant 
should  appear  to  be  in  perfect  health,  as  far  as  external  appearance  is  concerned,  is  by 
no  means  unusual.  “It  is  a  mistake  to  suppose  that  syphilitic  infant3  always  present  a 
withered  ‘old-man-like’  aspect  ;  in  many  instances,  although  manifesting  specific  local 
symptoms,  they  may  grow  well  and  remain  plump  and  fat.”  This  occurs,  I  believe,  with 
especial  frequency  when  the  child  does  not  suffer  from  a  skin  eruption,  and  under  such 
circumstances  condylomata  are  not  unfrequently  the  only  symptom  by  which  the  exis¬ 
tence  of  the  tint  is  proved. 

There  can,  I  think,  he  little  doubt  that  in  this  instance  it  was  the  blood,  and  not  the 
vaccine  lymnh,  which  was  the  source  of  contamination. 

Two  of  those  vaccinated  wholly  escaped,  and  as  they  were  two  of  the  youngest  on  the 
list,  and  mere  boys,  it  is  very  improbable  that  their  immunity  was  consequent  upon  their 
having  had  syphilis  before.  In  those  in  whom  chancres  occurred,  nearly  half  of  the  vac¬ 
cination  punctures  escaped.  Now,  lean  see  no  other  explanation  of  this  immunity  of 
some  persons  whilst  others  suffered,  and  immunity  of  some  vaccination  punctures  in  the 
same  person  in  whom  others  were  infected,  than  by  supposing  that  the  vaccine  virus  and 
the  syphilitic  virus  were  present  in  different  fluids,  and  that  it  was  possible  to  convey 
the  one  in  ail  its  vigor  without  necessarily  conveying  the  other,  It  is  important  in  ref¬ 
erence  to  this  point  to  note  that  the  two  individuals  who  have  escaped  were  the  two  who 
were  first  vaccinated,  since  it,  is  not  improbable  that  the  lymph  which  first  flowed  was 
unmixed  with  blood.  I  may  add  also  that  the  third  person  vaccinated  was  the  only  one 
in  whom  both  arms  were  done,  and  that  one  of  his  arms  escaped  whilst  the  second  suf¬ 
fered.  The  conjecture  may  be  permitted  that  it  was  when  obtaining  lymph  for  this  pa¬ 
tient’s  second  arm  that  the  operator  first  drew  blood. 

The  success  or  non-success  of  the  vaccination,  as  vaccination,  seems  to  have  had  noth¬ 
ing  to  do  with  the  induration  of  the  scars.  Some  scars  in  which  the  vaccination  vesicle 
had  not  “taken”  became  indurated,  whilst  many  punctures  which  did  “take”  escaped. 
Owing  to  the  patients  not  having  been  constantly  under  observation  after  the  vaccina¬ 
tion,  there  is  a  little  uncertainty  as  to  which  vesicles  were  well-developed  and  which 
failed,  since  we  are  obliged  to  rely  to  a  considerable  extent  on  the  statements  of  the  pa¬ 
tients  themselves.  There  seems  reason  to  believe  that  the  vaccination  failed  in  all  the 
spots  in  only  one  individual,  and  he  subsequently  had  several  indurated  chancres  at  the 
sites  of  puncture. 

The  period  of  incubation  seems  to  have  been  very  nearly  the  same  in  all  the  cases.  Two 
of  the  patients,  a  father  and  son,  noticed  that  their  scars  were  becoming  irritable  on  the 
same  day,  the  eighteentC  of  Maych,  a  little  more  than  five  weeks  after  the  vaccination, 
and  between  two  and  three  weeks  from  the  cicatrization  of  the  vaccine  vesicles.  In  all 
the  patients  the  spots  were  characteristically  indurated  when  I  saw  them  on  April  4th, 
exactly  two  months  from  the  date  of  the  vaccination.  It  would  have  been  of  great  inter¬ 
est  to  science  to  have  allowed  half  of  this  group  of  patients  to  abstain  from  any  specific 
treatment,  but,  on  the  other  hand,  it  appeared  a  paramount  duty  to  adopt  at  once  the 
very  best  means  for  their  recovery.  On  the  fourth  of  April,  they  all  commenced,  with 
one  exception,  the  use  of  mercury  in  small  doses,  and  the  application  of  black-wash.  In 
all  the  effect  of  the  remedy  upon  the  local  sore  was  most  definite.  Many  of  them,  at  the 
date  of  my  first  paper,  had  become  (after  eleven  days’  treatment)  quite  soft;  in  the 
course  of  a  week  none  of  them  displayed  a  degree  of  induration  which  would  have  been 
considered  characteristic,  and  several  which  had  been  ulcerated  were  healed. 

One  important  feature  in  this  group  of  cases  is  the  remarkably  close  similarity  which 
they  bear  to  each  other.  In  no  single  case  was  there  any  unusual  degree  of  inflammation 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


389 


of  the  vaccine  vesicle.  In  all,  as  far  as  the  patient’s  impressions  go,  the  vesicles  went 
through  a  usual  course,  and  in  all  a  period  intervened,  before  the  development  of  indu¬ 
ration,  during  which  the  cicatrix  was  quite  healthy.  As  the  patients  were  not  at  the 
time  under  medical  inspection  it  is  impossible  to  be  accurate  as  to  the  precise  day  on 
which  induration  of  the  cicatrices  began,  but  so  far  as  can  be  ascertained  there  is  reason 
to  believe  that  nine  out  of  the  eleven  began  to  complain  of  inflammation  of  the  scar 
towards  the  end  of  the  sixth  week.  At  the  end  of  the  eighth  week  these  nine  patients 
had  all  reached  the  same  stage.  In  the  other  two  cases  the  progress  was  about  a  fort¬ 
night  behind  hand. 

The  characters  assumed  by  the  sores  were,  with  some  minor  differences  as  to  size,  etc,, 
remarkably  similar.  Ulceration  occurred  in  all  excepting  two  patients,  and  in  one  of 
these  two,  out  of  three  chancres,  one  did  for  a  day  or  two  ulcerate  slightly.  In  one 
patient,  a  healthy,  florid  girl  of  seventeen,  three  glossy  buttons  of  induration  formed, 
but  never  passed  into  the  ulcerative  stage.  It  is  not  improbable,  however,  that  they 
were  arrested  by  the  influence  of  mercury.  Of  those  which  ulcerated  all  took  the  circu¬ 
lar  form,  and  in  all,  in  the  iirst  instance,  the  discharge  was  stated  to  have  been  “  glutin¬ 
ous.”  They  had  all  been  dressed  with  water  dressing  for  several  days  before  I  saw 
them,  and  had  much  improved  in  appearance  ;  some  of  them  were  secreting  healthy  pus, 
but  most  of  them  still  showed  deficiency  of  secretion.  None  of  the  patients  were  out  of 
health  at  the  time  of  the  occurrence,  but  they  varied  a  good  deal  as  to  temperament  and 
degree  of  vigor.  There  is  no  reason  to  think  that  any  of  them  had  suffered  from  syphilis 
before.  About  half  of  them  complained  that  they  had  headache  and  felt  more  or  less  un¬ 
well  during  the  time  that  the  sores  were  indurating.  One  young  man  was  confined  to 
his  bed  with  severe  aching  in  the  back,  vomiting,  and  general  febrile  disturbance,  all  of 
which  passed  off  in  a  few  days.  Most  of  them  had  more  or  less  enlargement  of  the 
glands  in  the  axilla,  but  none  did  it  occasion  any  material  pain  or  inconvenience.  In  all 
but  one  mercurial  treatment  was  commenced  on  the  fourth  of  April,  two  months  after 
the  vaccination,  and  about  a  fortnight  after  the  scars  had  begun  to  indurate,  and  the 
uniformity  with  which  all  the  sores  altered  in  character  under  its  exhibition  was  most  re¬ 
markable.  In  the  two  cases  in  which  ulceration  had  not  occurred,  the  sores  never  passed 
beyond  the  stage  of  induration.  The  sores  which  were  ulcerated  when  mercury  was  be¬ 
gun,  in  the  course  of  about  a  week  after  its  commencement,  began  to  discharge  healthy 
pus  and  to  show  florid  granulations.  Most  of  them,  as  already  stated,  were  healed 
within  a  fortnight,  and  after  three  weeks  the  majority  were  quite  sound  and  almost  free 
from  induration  in  all.  In  all  cases  the  mercurial  treatment  consisted  in  two  grains  of 
gray  powder  given  night  and  morning,  with  the  application  of  black-wash  under  gutta¬ 
percha  tissue.  About  half  the  patients  showed  slightly  the  influence  of  mercury  on  the 
mouth,  but  none  were  particularly  inconvenienced.  In  one  case  the  patient  did  not 
come  under  treatment  till  ten  days  after  the  others,  having,  indeed,  in  the  first  instance, 
consulted  a  homoeopath.  In  him  the  chancre  attained  a  size  twice  that  of  the  largest  of 
the  others. 

The  following  paragraphs  are  extracted  without  modification  from  my  first  report  (April 
25th),  as  I  have  special  reasons  for  wishing  to  preserve  their  original  form  : 

“As  already  stated,  none  of  the  patients  have  as  yet  displayed  any  of  the  persistent 
forms  of  skin  rash,  nor  have  any  shown  positive  ulceration  of  the  tonsils.  Several  of 
them  have  had  transitory,  but  definite,  eruptions  of  roseola,  and  in  several  the  skin  of 
the  abdomen  and  chest  is  slightly  mottled.  Three  of  them  to-day  display  about  the  neck, 
face  and  shoulders,  a  few  lichenoid  spots  of  doubtful  character. 

“  It  is  to  be  feared  that  before  long  we  shall  have  yet  more  definite  evidences  of  consti¬ 
tutional  contamination  in  some  of  these  patients  ;  but  in  the  pi'esent  stage  I  think  we  are 
quite  justified  in  deducing  the  following  conclusions  from  them  : 

“1st.  That  the  blood  of  a  child  suffering  from  inherited  syphilis  can,  if  inoculated, 
transmit  the  disease  with  great  certainty. 

“2d.  That  the  result  of  such  inoculation  of  blood  will  be  an  indurated  chancre. 

“3d.  That  if  multiple  inoculations  be  practiced,  multiple  chancres  may  be  produced. 

“4th.  That  a  period  of  incubation  between  the  inoculation  and  the  first  occurrence  of 
induration  about  the  prick  will  occur,  during  which  the  part  may  appear  perfectly 
healthy. 

“5tli.  That  the  period  of  incubation  prior  to  the  first  specific  induration  will  usually 
be  about  five  weeks. 

“6th.  That  it  is  quite  possible  for  vaccine  lymph  and  blood  to  be  transferred  at  the 
same  time,  and  for  each  to  produce  its  specific  results,  the  effects  of  the  syphilitic  inocu¬ 
lation  occurring  subsequently  to  those  of  vaccination. 

“7th.  That  it  is  quite  possible  to  vaccinate  successfully  from  a  syphilitic  infant  in  the 
stage  of  utmost  potency  as  regards  its  blood,  without  communicating  syphilis.” 

Tae  following  are  some  particulars  respecting  all  the  persons  vaccinated  in  this  series. 
The  cases  are  arranged  according  to  the  order  in  which  vaccination  was  performed: 


390 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


No.  1.  Master  W - ,  a  youth  of  14.  He  was  vaccinated  in  three  places,  all  of  which 

took,  and  went  through  their  usual  course.  No  ill  consequences  followed.  On  April  8, 
I  examined  his  scars,  and  found  them  pale  and  quite  normal. 

No.  2.  W.  N - ,  set.  16.  Only  one  of  three  spots  took.  No  ill  consequences  followed. 

On  tbe  eighth  of  April,  I  found  the  scar  of  the  vesicle  which  succeeded  pale  and  healthy. 

No.  3.  Mr.  T.  B - ,  set..  20,  a  young  man  of  fair  complexion  and  somewhat  delicate  ap¬ 

pearance.  As  he  had  no  scars  of  a  former  vaccination,  it  was  thought  best  to  vaccinate 
liira  on  both  arms.  This  was  accordingly  done  in  three  places  on  each;  in  two  or  three 
on  each  arm  the  vaccination  took  and  scabs  resulted.  He  left  the  establishment  shortly 
afterwards,  and  at  the  time  of  my  first  visit  I  did  not  see  him.  Having  obtained  bis  ad¬ 
dress,  he  was  subsequently  induced  to  come  to  my  house.  This  was  at  the  end  of  two 
months  after  vaccination.  He  had  then  one  large  ulceration  with  indurated  edges  and 
prominent  granulations  in  the  middle.  This  chancre,  which  was  as  large  as  a  florin,  had 
resulted  from  the  confluence  of  two  vaccination  sores.  He  stated,  as  regards  the  vacci¬ 
nation,  that  the  scabs  fell  within  three  weeks,  and  that  the  sores  then  seemed  quite  well. 
During  the  sixth  week  two  of  the  spots  on  his  left  arm  inflamed  and  became  hard,  and 
during  the  following  week  he  had  a  good  deal  of  febrile  disturbance.  He  had  an  enlarged 
but  sottish  gland  in  the  left  axilla.  Mercurial  treatment*  was  commenced  in  the  end  of 
the  ninth  week,  and  continued  for  two  months.  The  chancre  was  quite  healed  in  about 
a  month,  but  the  scar  remained  hard  and  dusky.  He  had  a  few  suspicious  lichen  spots 
in  the  thirteenth  week,  but  nothing  characteristic.  He  never  had  any  sore  throat,  and 
his  general  health  remained  throughout  good. 

No.  4.  Mary  Jane  L — ,  let.  18.  Three  spots  took  and  went  through  their  stages.  About 
six  weeks  after  the  vaccination  all  three  became  inflamed,  and  they  subsequently  in¬ 
durated.  On  April  4,  they  were  all  indurated  and  superficially  ulcerated  (see  sketch). 
There  was  an  enlarged  gland  in  the  axilla,  movable,  but  not  very  hard.  During  the  pre¬ 
ceding  week  she  had  had  some  febrile  disturbance.  Mercurial  treatment  was  commenced 
at  the  end  of  the  eighth  week,  and  was  pushed  to  sliglitptyallism.  She  subsequently  had 
some  diarrhoea,  and  could  not  continue  the  mercury  regularly,  Tbe  chancres  soon  healed. 
In  the  thirteenth  week  she  reported  that  she  had  a  rash,  which  came  and  went,  but  I 
never  saw  anything  positive.  She  was  of  strumous  diathesis,  and  a  large  glandular  mass 
in  the  neck,  which  had  shown  itself  in  the  eighth  week,  persisted  ever  afterwards.  In 
the  middle  of  July,  all  specific  treatment  having  been  suspended  for  more  than  two 
months,  she  had  a  rash  on  the  neck,  fronts  of  arms,  etc.  It  consisted  of  small,  slightly 
scaly  papules,  of  dusky  color.  She  had  also  symmetrical  ulcers  in  the  tonsils.  Mercurial 
treatment  was  at  once  recommenced,  and  the  rash  soon  began  to  fade.  She  was  seen  a 
few  days  later  by  the  Society’s  Committee.  On  August  1,  all  traces  of  the  rash  had  dis¬ 
appeared,  hut  the  ulcers  in  the  tonsils  persisted.  On  September  4  she  was  seen  by  Mr. 
Smith,  secretary  of  the  committee.  At  this  date  she  had  no  rash,  but  the  ulcers  in  the 
tonsils  were  still  characteristic. 

No.  5.  Caroline  R - ,  set.  24,  stout  and  florid,  was  vaccinated  in  three  spots,  two 

of  which  took  slightly  and  one  well.  After  they  had  been  for  some  time  soundly 
healed,  they  relapsed  about  the  twentieth  of  March  and  became  red  and  irritable.  She 
had  at  this  time  backache  and  flying  pains.  There  was  no  swelling  in  the  axilla.  Mer¬ 
curial  treatment  was  commenced  at  the  end  of  the  eighth  week,  and  was  pushed  to  de¬ 
cided  salivation  at  the  end  of  ten  days,  after  which  she  took  only  one  pill  daily.  At  the 
end  of  a  month  the  sores  were  all  healed  and  the  scars  soft.  She  had  on  several  occa¬ 
sions  shown  a  few  suspicious  spots  about  the  neck,  but  characteristic,  and  she  had  had 
no  sore  throat  Throughout  she  had  complained  a  good  deal  of  rheumatoid,  etc.,  but 
she  kept  at  her  work.  In  the  middle  of  July,  at  the  same  time  as  in  the  preceding  case, 
a  characteristic  rash  attended  with  ulcers  in  the  tonsils  showed  itself.  Mercury,  which 
had  been  suspended  for  two  months,  was  resumed,  and  the  rash  soon  disappeared.  On 
the  first  of  August  she  was  quite  -well,  with  the  exception  of  two  or  three  spots  which 
persisted  on  her  neck.  In  the  beginning  of  September,  she  had  a  relapse  of  ulce  ration 
in  one  tonsil,  but  it  was  very  slight.  Her  general  health  at  this  time  was  good. 

No.  6.  Annie  W - ,  a  florid,  robust  girl,  set.  17.  The  three  vaccination  spots 

took  well,  went  through  their  normal  stages,  and  healed.  On  April  4  (eighth  week)  the 
outer  one  showed  slight  induration,  but  was  not  in  any  degree  ulcerated.  The  other  two 
were  reddened,  but  not  at  all  hard. 

She  said  they  were  redder  than  they  had  been  a  week  before,  and  that  they  were  be¬ 
ginning  to  itch.  She  felt  perfectly  well.  Three  days  later  all  three  spots  had  beco  me 
slightly  harder.  None  of  them  ever  passed  into  open  ulcers,  and  under  mercurial  treat¬ 
ment  all  induration  disappeared  in  the  course  of  three  weeks.  I  believe  she  took  the 
mercury  afterwards  very  irregularly.  No  constitutional  symptoms  of  any  kind  ever- 
showed  themselves. 


*By  “mercurial  treatment”  tin  oughont  this  paper  may  he  understood  the  careful  use  of  black -wash  applied 
to  the  sere  three  times  daily,  and  protected  with  oil-silk,  and  the  administration  internally  of  two  grains  ot 
gray  powder  tw  ice  or  three  times  a  day,  according  to  circumstances. 


Spurious  Vaccination Joseph  Jones ,  M.  1). 


391 


No.  7.  Lucy  L - ,  set.  20.  All  the  four  vaccination  punctures  took  well,  and  healed  in 

due  course.  Nothing  followed  until  the  last  days  of  March  (beginning  of  eighth  week), 
when  the  two  inner  spots  became  red,  hard,  and  irritable.  On  April  4,  the  two  outer  scars 
still  showed  no  sign  of  irritation,  but  the  two  inner  ones  were  of  a  dusky  red,  somewhat 
raised,  hard,  and  covered  with  thin  epidermit  scale.  She  complained  that  they  felt  sore. 
She  had  no  other  symptoms.  No  axillary  bubo.  In  this  case  the  chancres  never  ulcerated. 
Under  the  influence  of  mercury  the  induration  disappeared.  For  a  short  time  in  the 
tenth  week  her  tonsils  were  suspiciously  inflamed,  but  she  never  had  any  rash.  Cod  liver 
oil  was  given  most  of  the  time,  as  she  was  in  delicate  health,  and  had  a  cough. 

No.  8.  Mr.  T - ,  ait.  20.  Three  vaccination  places  took,  and  the  fourth  did  not. 

These  scars  remained  quite  sound  until  April  1,  (eighth  week).  I  saw  him  on  April  8,  and 
found  one  of  the  scars  inflamed,  slightly  hard  at  the  base,  and  covered  with  a  scab.  The 
other  three  were  quiet.  He  said  that  he  felt  well.  There  were  some  hard  glands  in  the 
axilla.  Mercury  was  at  once  commenced,  and  the  sore,  which  had  ulcerated,  soon  healed, 
The  mercury  never  produced  any  ptyalisni,  and,  excepting  a  little  headache,  he  felt  quite 
well  throughout.  On  the  fifth  of  May  the  scar  was  sound,  but  still  hard,  and  the  glands 
in  the  axilla  could  still  be  felt.  My  notes  mention  “some  small  spots  on  neck  and 
shoulders,  fairly  characteristic.”  The  spots  alluded  to  had  disappeared  at  my  next  visit. 
He  subsequently  remained  quite  well  until  the  middle  of  July,  when  he  had  a  general 
roseolous  eruption,  -which,  however,  disappeared  in  a  week,  when  mercury  was  resumed 

No.  9.  Mr.  H - ,  get.  22,  of  fair  complexion  and  delicate.  Lymph  was  inserted  at 

three  places,  and  good  vesicles  developed  at  t-wo.  They  all  healed  well,  but  about  March 
20  the  inner  one  began  to  inflame.  On  April  4,  when  I  saw  him,  he  complained  of  hav¬ 
ing  felt  dull  and  heavy  during  the  last  week.  The  spot,  which  had  inflamed,  was  raised 
and  hard.  On  each  tonsil  there  was  a  slightly  marked  patch  of  suspicious  appearance, 
but  not  actually  ulcerated.  Mercury  was  commenced  at  this  date.  The  chancre  soon 
healed.  The  throat  was  slightly  sore  for  about  a  week,  and  after  this,  excepting  some 
complaint  of  frontal  headache,  he  had  no  symptoms.  On  May  5,  the  chancre,  which  had 
been  healed  for  more  than  a  week,  scarcely  showed  any  induration.  He  felt  quite  well, 
and  had  no  rash.  Mercury  was  continued  once  a  day  for  a  month  longer,  and  theu 
disused. 

No.  10.  Mr.  W - ,  set.  18,  a  rather  delicate  young  man  of  dark  complexion.  He  was 

vaccinated  in  three  places,  but  none  of  them  took.  The  inner  one  inflamed  a  little,  but 
soon  healed.  On  the  twenty-second  of  March  the  inner  one  had  again  inflamed,  and  was 
becoming  hard.  On  April  1  he  felt  ill,  had  backache,  thirst  and  headache;  and  on  the 
second  a  succession  of  slight  rigors,  with  frequent  sickness,  came  on.  When  I  saw  him, 
on  April  4,  he  was  in  bed,  on  account  of  his  backache  and  feverishness.  There  was  an 
enlarged  gland  in  his  axilla,  and  the  skin  of  his  abdomen  was  a  little  mottled.  Only 
one  of  the  vaccination  spots  was  affected,  and  it  was  exactly  like  those  in  the  other 
cases — raised,  hard  and  inflamed.  Nothing  could  be  seen  on  his  tonsils.  On  April  8  he 
was  much  better,  having  lost  his  backache.  He  stated  that  on  the  seventh  his  body  and 
face  were  covered  with  a  blotchy  rash,  but,  with  the  exception  of  a  very  slight  mottling 
of  the  abdomen,  this  had  disappeared  on  the  eighth.  On  the  fifth  of  May  he  had  conges¬ 
tion  of  the  right  eye  and  circumorbital  pain,  but  no  positive  irritis  resulted.  At  the 
same  time  he  had  a  lichenoid  eruption  on  shoulders,  arms  and  face,  hut  as  it  was  mixed 
with  acne,  to  which  he  had  been  previously  liable,  it  was  not  easy  to  be  confident  as  to 
its  character.  On  account  of  diarrhoea,  the  mercury  had  been  omitted. 

No.  11.  Mr.  W - ,  aged  45,  a  married  gentleman,  the  father  of  a  healthy  family,  and 

who  had  never,  at  any  time,  suffered  from  syphilis.  He  was  vaccinated  in  three  places, 
two  of  which  took,  went  through  their  stages  and  cicatrized.  The  middle  one  of  the 
three  did  not  take.  On  or  about  March  18,  all  three  inflamed,  and  when  I  saw  them,  on 
April  4,  they  were  all  indurated  and  ulcerated.  He  had  no  enlarged  glands,  nor  any  other 
symptom.  On  April  8,  his  condition  was  much  the  same;  lie  was  taking  mercury 
twice  a  day;  the  thermometer  had  been  used  regularly,  and  had  not  shown  any  elevation 
of  temperature.  On  the  11th,  the  mercurial  was  omitted,  as  he  was  decidedly  salivated. 
On  the  14th,  two  of  the  sores  were  quite  healed,  and  the  other  showed  healthy  granula¬ 
tions.  After  this  he  continued  the  liberal  use  of  black- wash,  but  took  no  more  mercury 
internally.  From  the  10th  to  the  24th,  his  mouth  was  slightly  sore,  and  the  mercurial 
odor  wras  perceptible  in  his  breath.  Subsequently,  he  remaiued  quite  well  as  regards 
syphilitic  symptoms  until  the  latter  end  of  June.  We  had  sent  him  to  the  seaside,  as  he 
had  not  regained  quite  his  ordinary  strength.  Whilst  there  he  rapidly  improved,  but  a 
copious  eruption  came  out  on  his  scrotum,  thighs  and  scalp.  He  thought  it  had  been 
excited  by  bathing.  He  returned  to  town  three  weeks  later,  and  I  saw  him  in  the  mid¬ 
dle  of  July.  His  scrotum,  penis,  and  the  inner  sides  of  his  thighs,  were  covered  with  flat- 
topped  pa'pules  and  patches  of  psoriasis  of  the  most  characteristic  kind.  He  had  no  rash 
worth  mention  on  other  parts  of  his  body,  but  his  scalp,  which  was  bald,  was  covered 
with  small  patches  of  porrigo.  Under  the  use  of  mercurial  oiutment  and  small  doses  of 
mercury  internally,  both  the  scrotum  and  scalp  rapidly  healed. 


Spurious  Vaccination :  Joseph  Jones ,  M.  J). 


392 


No.  12.  Mr.  W - ,  Jr.,  ait.  18,  son  of  tlie  subject  of  Case  11.  He  was  of  brown  com¬ 

plexion  and  in  tolerable  health,  but  bad  been  for  years  the  subject  of  enlarged  tonsils. 
Three  out  of  four  of  bis  vaccination  spots  took,  went  through  their  usual  stages,  and 
healed.  On  the  eighteenth  of  March,  two  of  the  three  spots  which  had  taken  became  a 
little  inflamed  and  irritable,  and  during  the  next  week  .they  gradually  indurated.  He 
consulted  his  surgeon  about  them  on  the  24th,  and  on  April  4  I  saw  him.  The  outermost 
of  the  three  spots  then  showed  a  healthy  cicatrix,  but  the  inner  and  middle  ones  were 
inflamed,  slightly  raised,  superfleially  ulcerated,  and  decidedly  indurated  at  the  base. 
He  had  no  other  symptoms.  No  definite  glandular  swelling.  Mercury  was  prescribed, 
and  under  its  influence  the  sores  softened  and  healed.  He  was  never  positively  salivated, 
hut  the  occurrence  of  slight  diarrhoea  several  times  interrupted  the  mercurial  course. 
Up  to  the  present  date  he  has  not  had  auv  secondary  symptoms,  with  the  exception  of  a 
doubtful  roseolous  rash  in  the  beginning  of  May.  He  took  mercury  in  all  tor  about  a 
month. 


SECOND  SERIES  OF  OASES. 


Synopsis — Unquestionable  Symptoms  of  Constitutional  Syphilis 
in  Nine  Children  who  had  been  Yaccinated  from  the  same 
Patient — Suspicious  Symptoms  in  Six  Others,  and  Entire  Es¬ 
cape  of  a  Certain  Number — Vaccinifer  a  Fine  Healthy  Look¬ 
ing  Child,  but  with  Slight  Local  Symptoms  Indicative  of  In¬ 
herited  Syphilis. 

On  May  5,  1871,  two  children  were  brought  under  the  care  of  my  friend  and  colleague, 
Mr.  Warren  Tay,  on  account  of  syphilitic  eruptions.  They  were  a  brother  and  sister, 
aged  respectively  four  years  and  sixteen  months,  and  in  both  the  syphilitic  rash  was 
very  definite.  In  searching  for  its  cause  Mr.  Tay  found  that  about  seven  weeks  pre¬ 
viously  they  had  been  vaccinated,  and  that  the  vaccination  spots  were  at  the  present 
time  unhealed,  and  with  very  decided  induration  at  their  bases.  Mr.  Tay  now  brought 
the  cases  to  me,  and  I  am  indebted  to  his  courtesy  for  permission  to  investigate  the  facts 
respecting  them,  and  also  for  much  help  in  doing  so.  We  obtained  from  the  mother  of 
the  children  the  name  of  the  vaccinator,  and  on  ajiplication  to  him  were  at  once  supplied 
with  his  vaccination  register,  and  allowed  to  copy  out  the  names  and  addresses  of  twen¬ 
ty-four  other  patients  who  had  been  vaccinated  at  the  same  time  from  the  same  vaccini¬ 
fer.  Nothing  had  occurred  to  excite  the  vaccinator’s  suspicions,  not  a  single  one  of  this 
series  having  been  taken  hack  to  him  on  account  of  the  unhealthy  condition  of  the  arm. 
On  making  inquiries  at  the  houses  of  the  patients,  however,  we  found  that  no  fewer  than 
nine  had  chancres  on  their  arms,  and  that  six  were  suffering  from  well-marked  and 
copious  syphilitic  rash.  Two  of  them  had  been  under  medical  care  for  these  symptoms, 
but  not  in  a  single  case  had  the  real  nature  of  the  disease  been  suspected.  1  will  state 
seriatim  the  chief  facts  respecting  these  cases  in  this  series,  hut  it  will  he  convenient 
first  to  mention  those  which  concern  the  vaccinifer. 

HISTORY  OF  THE  VACCINIFER. 

I  visited  the  child  at  its  home,  the  parents  having  no  knowledge  of  the  object  of  my 
visit.  I  found  it  a  stout,  well-grown  male  infant,  of  seven  months  old.  Thus,  he  would 
he  four  months  old  at  the  date  of  vaccination.  His  mother  stated  that  he  was  selected 
as  a  vaccinifer  from  amongst  several  others,  as  being  the  most  healthy  present,  and  that 
his  vaccination  spots  were  very  good  ones.  They  healed  afterwards  quite  well,  and  the 
scars  remained  sound.  He  still  looked  healthy,  and  was  well  grown  and  cheerful,  Ex¬ 
cepting  a  little  transitory  “  tooth-rash,”  probably  lichen,  on  the  face,  he  had  had  no 
eruption.  His  head  was  decidedly  large,  and  the  fontanelles  widely  open.  This  had,  his 
mother  said,  only  been  noticed  for  a  few  weeks.  Latterly,  several  neighbors  had  told  her 
that  he  had  “  water  on  the  brain.”  I  inquired  as  to  snuffles,  ana  she  replied  at  once  and 
emphatically,  “Yes,  he  has  snuffled  a  grei^  deal.”  There  was  no  trace  of  rash  in  the 
child’s  skin  at  the  time  of  my  visit,  hut  at  the  anus  was  a  single  small  condylomatous 
patch  just  healing.  This  had  never  attracted  his  mother’s  attention.  He  was  said  to 
have  had  thrush.  His  mother  was  a  young  and  healihy-looking  woman,  who  had  been 
married  two  years.  I  did  not,  of  course,  ask  her  any  direct  questions. 

Immediately  afterwards  I  called  on  the  father  of  the  child,  and  in  answer  to  a  direct 
question,  he  denied  very  positively  having  ever  been  the  subject  of  venereal  disease. 
On  a  subsequent  occasion  he  submitted  to  a  personal  examination  at  my  house,  and  we 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


393 


failed  to  detect  anything  of  a  nature  to  cast  suspicion  on  his  denial.  I  saw  the  infant 
two  or  three  times  during  the  next  six  weeks,  but  no  symptoms  of  a  more  definite  char¬ 
acter  showed  themselves.  The  condyloma  soon  healed,  and, with  the  exception  of  a  slight 
tendency  to  hydrocephalus,  the  infant  at  the  time  I  last  saw  it  might  have  been  regarded 
as  a  specimen  of  excellent  health.  As  regards  its  condition  at  the  date  of  vaccination, 
I  may  state  that  the  parents  of  several  of  those  vaccinated  from  it  subsequently  men¬ 
tioned  to  me  its  very  healthy  appearance. 

No  trustworthy  evidence  could  be  obtained  as  to  whether  blood  was  or  was  not  trans¬ 
ferred  in  the  act  of  vaccination.  The  vaccinator,  who  is  a  very  able  and  careful  sur¬ 
geon,  assured  me  that  it  was  his  custom  to  avoid  blood-stained  lymph,  and  several  of  the 
women  who  witnessed  the  proceedings  told  me  that  they  did  not  observe  any  bleeding. 
In  addition  to  the  number  of  children  vaccinated  directly  from  its  arms,  some  tubes  were 
also  charged  with  its  lymph.  These  tubes,  having  been  mixed  with  others,  could  not  be 
traced. 

The  following  are  the  particulars  of  all  the  patients  vaccinated  from  this  vaccinifer : 

No.  1.  Arthur  Edward  T - ,  set.  16  months,  one  of  those  first  seen  by  Mr.  Tay.  He 

had  been  vaccinated  for  the  first  time  on  February  13,  and  five  of  the  punctures  were 
successful.  The  spots  healed,  but  subsequently  became  hard.  When  he  applied  to  Mr. 
Tay,  in  May,  the  scars  were  decidedly  indurated,  but  not  ulcerated  ;  there  were  enlarged 
glands  in  the  axilla;  he  had  symmetrical  ulcers  on  the  tonsils,  and  a  moderately  copious 
rash  of  mixed  roseola  and  psoriasis  on  the  trunk  and  limbs.  He  was  treated  by  mer¬ 
cury,  and  his  symptoms  slowly  disappeared. 

No.  2.  Elizabeth  T - ,  set.  4  years,  sister  of  the  above  patient,  She  was  vaccin¬ 

ated  for  tlie  first  time  at  the  same  date,  and  five  of  the  punctures  took  well.  They  went 
their  usual  stages  and  healed.  Afterwards  the  scars  inflamed  and  ulcerated.  When  she 
was  seen  by  Mr.  Tay  on  May  5,  she  presented  superficial  sores  with  slightly  indurated 
bases,  and  covered  with  a  good  deal  of  scab  on  the  seat  of  the  vaccination  scars.  The 
glands  in  the  armpit  were  enlarged.  She  showed  deep  symmetrical  ulcers  on  the  tonsils 
nearly  healed,  and  she  had  a  copious  rash  of  papules  and  small  scaly  patches  on  the 
body,  the  color,  arrangement,  and  general  appearances  of  which  were  most  characteris¬ 
tic.  This  eruption  was  most  symmetrical,  and  occurred  especially  on  the  back  of  the 
neck,  the  bend  of  each  elbow,  and  the  thighs  and  hips.  Under  mercurial  treatment  the 
chancres  healed  and  the  rash  disappeared. 

No.  3.  William  C— — ,  set.  10  years.  His  was  a  second  vaccination,  but  three  of  the 
punctures  were  followed  by  good  vesicles.  The  vaccination  spots  were  healed.  He  be¬ 
came  the  subject  of  rheumatoid  pains,  and  had  a  copious  rash  over  the  whole  body. 
When  seen  by  me  at  the  end  of  thirteenth  week  he  had  already  been  for  several  weeks 
under  medical  treatment.  The  vaccination  chancres  were  just  healed,  but  were  still  in¬ 
flamed,  indurated,  of  a  dusky  red  color,  and  covered  with  a  dry  papery  scab.  There  was 
a  gland  as  large  as  a  walnut  in  the  axilla.  Eaeh  tonsil  showed  a  well-marked  gray-based 
ulceration.  The  rash,  although  evidently  fading,  was  still  abundant.  It  occurred  sym¬ 
metrically  on  the  neck,  arms,  trunk,  and  thighs.  It  was  copious  both  on  the  backs  and 
fronts  of  the  arms,  especially  so  on  the  outsides  of  the  thighs. 

No.  4.  Eliza  T - ,  set.  14.  a  re-vaccination  ;  four  or  five  of  the  punctures  took  ;  the 

crusts  fell  in  about  a  fortnight,  aud  the  scars  remained  sound  for  three  weeks  after¬ 
wards.  Five  weeks  after  vaccination  they  inflamed  and  became  hard,  and  “  a  white  skin 
came  over  them,”  but  they  never  reulcerated.  She  had  a  painful  lump  in  the  armpit 
during -the  first  week  after  vaccination,  but  it  subsequently  disappeared.  During 
the  twelfth  week  she  first  noticed  an  eruption  on  the  chest,  and  at  this  time  she  had 
some  cough  and  felt  ill.  as  if  she  had  taken  cold.  She  was  now  placed  under  the  care  of 
a  surgeon.  I  first  saw  heron  May  17,  the  first  day  of  the  fourteenth  week.  At  that  date 
her  vaccination  spots  were  soundly  healed,  but  the  scars  were  dusky  and  covered  with  a 
papery  scale;  none  of  them  were  indurated  There  was  a  slightly  enlarged  movable 
gland  in  tne  armpit.  She  had  symmetrical  ulcers  in  the  tonsils,  with  white  borders. 
There  was  a  sparing  eruption  of  dusky  lichen  spots  on  her  chest,  chiefly  below  the  nip¬ 
ples.  There  were  a  very  few  spots  also  on  the  chest  and  upper  part  of  the  neck,  but 
none  on  the  arms.  Up  to  this  date  the  patient  had  taken  no  mercury. 

No.  5.  Maria  II - ,  set.  3 ;  a  first  vaccination;  four  punctures  took.  When  visited 

in  the  fourteenth  week  she  was  found  to  have  symmetrical  ulcers  in  the  tonsils,  a  slightly 
enlarged  gland  in  the  axilla,  and  an  eruption  of  dusky  psoriasis  on  the  back  and  outer 
sides  of  the  thighs.  One  of  the  vaccination  scars  was  slightly  indurated  and  dusky, 
with  a  thin  papery  scale  ;  the  others  were  sound.  The  rash  had  only  been  noticed  for  a 
few  days.  The  child  had  been  for  some  time  under  the  care  of  a  surgeon  for  “inflamma¬ 
tion  of  the  lungs.”  Up  to  this  date  the  child  had  taken  no  mercury,  and  the  treatment 
afterwmrds  was  conducted  with  extreme  irregularity.  On  September  6,  after  an  interval 
of  two  months,  during  which  the  child  was  lost  sight  of,  it  again  came  under  care  on 
account  of  condylomata  at  the  anus. 

No.  6.  Eliza  M - ,  set.  17 ;  revaccination,  four  places  took.  On  May  16,  end  of  the 

thirteenth  week,  the  sores  had  only  just  healed,  and  their  scars  were  slightly  indurated, 


394 


Spurious  Vaccination :  Joseph  Jones ,  M.  J). 


dusky,  and  covered  with  a  dry  scale.  There  was  a  slightly  enlarged  gland  in  the  axilla, 
and  she  had  a  few  scaly  papules  of  dusky  red  color  on  the  upper  parts  of  the  legs,  but 
none  elsewhere.  She  was  florid  and  in  good  health. 

No.  7.  This  patient,  Hannah  S - ,  was  not  found. 

No.  8.  Elias  W - ,  set.  1  year;  a  first  vaccination  ;  four  punctures  took.  At  the  end 

of  the  twelfth  week  the  sores  were  hot  healed,  but  were  covered  with  porrigo  scab. 
There  was,  however,  no  evidence  of  syphilis,  and  the  child  had  been  the  subject  of 
porrigo  before  vaccination. 

No.  9.  Mary  Anne  O— — ,  set.  11;  a  re-vaccination;  five  places  took.  The  sores  healed 
very  slowly,  and  had  only  just  closed  at  the  end  of  the  thirteenth  week.  Their  scars 
were  then  dusky  and  red,  with  a  thin  dry  scale  and  slight  induration.  There  were  a  few 
dusky  papules  on  the  back  of  her  neck,  and  one  in  front  of  the  right  elbow.  The  patches 
were  either  smooth  and  glossy,  or  covered  with  a  thin  scale.  There  was  a  large  indolent 
swelling  in  the  axilla.  The  child  had  not  been  out  of  health,  and  no  treatment  had  been 
adopted. 

No.  10.  Amelia  O - ,  set.  5  years;  first  vaccination;  five  places  took.  The  sores 

healed  in  about  five  weeks,  and  the  scars,  when  examined,  at  the  end  of  the  thirteenth 
week,  were  scaly  and  somewhat  congested,  but  not  indurated.  The  axillary  glands  were 
slightly  enlarged.  She  had  no  eruption  excepting  some  patches  of  dry  eczema  on  the 
face.  It  is  probable  that  she  was  not  syphilitic. 

No.  11.  Frances  C - ,  ait.  4  years.  I  do  not  know  more  respecting  this  child  than  that 

the  vaccination  sores  healed  slowly,  and  that  during  the  eighth  week  she  had  a  rash  of 
red  pimples.  She  was  not  seen. 

No.  12.  Alice  C- - ,  set.  5-J  years,  sister  of  the  above.  Facts  as  to  vaccination  very 

similar. 

No.  13.  Henry  C - ,  set.  8  years,  brother  of  the  above.  On  May  8,  end  of  twelfth  week, 

two  or  three  of  his  vaccination  spots  were  still  unhealed  and  covered  with  porrigo  scab. 
He  was  reported  to  have  had  a  rash  like  his  sisters,  but  neither  in  him  nor  them  was  there 
anything  positively  syphilitic. 

No.  14.  Emily  Julia  J — — ,  set.  6;  first  vaccination ;  five  places  took.  The  places  healed 
up  at  the  end  of  the  third  week,  but  subsequently  inflamed  and  reopened.  Oh  May  17, 
fourteenth  week,  the  four  lower  spots  were  healed,  but  hard,  glossy  and  dusky.  The 
upper  one  was  covered  with  a  dry  pus-scab,  and  its  base,  as  large  as  a  shilling,  consid¬ 
erably  indurated.  She  had  an  enlarged  gland  on  the  border  of  the  axilla.  The  lower 
part  of  the  chest,  the  whole  of  the  abdomen  aud  the  back  were  covered  with  a  lichenoid 
rash,  and  there  were  a  few  spots  on  the  front  of  the  elbows  and  on  the  thighs.  The  rash 
had  probably  been  out  about  a  fortnight.  There  were  symmetrical  ulcers  in  the  tonsils, 
and  she  had  been  low-spirited  and  ailing.  Mercurial  treatment,  one  grain  of  gray  pow¬ 
der  twice  a  day,  was  commenced  on  the  seventeenth.  On  the  thirtieth,  all  traces  of  the 
rash  and  of  the  ulcers  in  the  throat  had  disappeared,  and  she  was  in  good  health.  The 
vaccination  scars  were  still  dusky  and  somewhat  indurated. 

No.  15,  Alfred  J - ,  set.  9,  and  brother  of  the  above.  A  first  vaccination;  five 

places  took,  and  all  healed  during  the  third  week.  They  afterwards  inflamed  and  re¬ 
opened.  In  the  beginning  of  the  fourteenth  week  the  scars  were  dusky,  and  there  was 
an  enlarged  gland  in  the  axilla.  He  had  no  rash  of  a  positive  character,  but  a  suspicious 
mottling  of  the  skin  of  the  abdomen. 

No.  26  Annie  J - ,  set.  3  years,  sister  of  the  above.  All  the  four  vaccination  punc¬ 

tures  healed  well  in  the  usual  time,  but  subsequently  reopened.  An  abscess  formed  in 
the  armpit  and  broke.  It  was  said  that  she  had  scarlet-fever  soon  after  the  vaccination. 
At  the  beginning  of  the  fourteenth  week  all  the  sores  were  well  healed,  but  the  scars 
were  slightly  dusky.  She  had  no  rash. 

A  young  woman  who  was  vaccinated  from  this  child  suffered  no  ill  consequences. 

No.  17.  Herbert  D - ,  set.  5  years.  In  this  case  nothing  unusual  occurred. 

No.  18.  Alfred  George  H - ,  set.  1  year.  In  this,  as  in  the  preceding,  the  vaccination 

was  successful  aud  without  any,  untoward  remit.  Both  of  them  were  first  vaccinations, 
and  in  each  some  places  took. 

No.  19.  Eliza  C  -  — ,  set.  16  months  In  this  instance  the  vaccination,  first,  was  not 
successful,  but  nothing  followed  it. 

No.  20.  Rose  Jane  B - .  set.  3  months.  I  did  not  succeed  in  obtaining  any  informa¬ 

tion  about  the  child,  and  the  same  remark  applies  to  the  three  following  cases. 

No.  21.  Rosiua  T - . 

No.  22.  Daniel  C - . 

No.  23.  John  C - -. 

No  24.  Caroline  W — ,  set.  13  years ;  a  re  vaccination  ;  three  places  took.  The  sores 
never  quite  healed.  About  the  fifth  week  they  inflamed  considerably.  An  abundant 
eruption  appeared  in  the  eighth  week,  aud  at  the  same  time  she  failed  in  health,  lost  her 
appetite,  and  had  pains  in  her  limbs.  When  seen  in  the  beginning  of  the  fourteenth 
week  she  had  a  large  open  sore  on  her  arm,  with  indurated  edges,  and  prominent  florid 
granulations  in  the  center.  This  sore  was  formed  by  the  coalescence  of  two  ;  a  third  was 


Spurious  Vaccination :  Joseph  Jones ,  M.  Z). 


395 


healed,  hut  indurated.  She  had  symmetrical  excavated  ulcers  in  the  tonsils,  and  en¬ 
larged  glands  in  the  axilla  and  back  of  the  neck.  She  had  a  copious  eruption  of  dusky 
flat-topped  papules,  occurring  on  almost  all  parts,  excepting  the  face,  and  there  was  also 
a  single,  round,  condylomatous  patch  on  her  tongue.  A  sketch  of  her  arm  was  taken  on 
May  19,  and  on  the  same  date  she  was  seen  by  many  surgeons.  Mercurial  treatment 
was  commenced  on  May  17.  On  May  31,  she  was  rapidly  getting  well,  the  rash  having 
almost  disappeared  and  the  sore  being  nearly  healed.  On  June  21,  the  sore  on  the  arm 
was  healed,  but  its  scar  was  dusky  and  covered  with  scales  ;  the  only  constitutional 
symptoms  which  remained  were  a  few  spots  on  the  neck  and  the  condyloma  on  the  tongue. 
Subsequently  this  child  got  quite  well,  but  she  had  to  take  mercury  for  more  than  two 
months.  Towards  the  end  of  July  she  was  again  under  care  for  a  small  condyloma  at 
the  anus,  but  it  soon  disappeared  under  treatment. 

No.  25.  Harriet  W— ,  set,  15  years  ;  revaccination  ;  successful ;  no  ill  consequences. 

No.  29.  John  R — ,  aet,  8  years.  A  successful  first  vaccination.  No  ill  consequences. 


REPORT  OF  A  SUB-COMMITTEE  OF  THE  ROYAL  MEDICAL  AND  CHIRUROICAL 
SOCIETY  ON  SOME  OF  THE  CASES  RELATED  BY  MR.  HUTCHINSON  IN  THE 
PAPERS  READ  AT  THE  MEETINGS  OF  THE  SOCIETY  ON  APRIL  25  AND 
MAY  9,  1871. 

On  May  16,  1871,  we  saw,  in  company  with  Mr.  Hutchinson,  the  following  cases : 

The  vaccinifer  of  the  first  series  of  cases  reported  on  April  25,  and  three  persons  (Cases  1,  2  and  3)  who 
were  vaccinated  from  this  child . 

Vaccinifer  (Ho.  1),  female,  set.  7  months.  Had  been  used  on  February  7  for  vaccinating  the  series  of 
cases  reported  by  Mr.  Hutcliipson  on  April  25. 

This  child  is  hydrocephalic  ;  its  head  is  much  elongated  and  widened  posteriorly  ;  the  fontanelle  is  some¬ 
what  more  open  than  usual.  It  is  pallid,  hut  not  unhealthy  looking.  There  are  five  marks  on  the  left  arm 
from  vaccination,  which  are  quite  healed.  Ho  eruption  can  be  seen  anywhere;  tlie  anus  and  genitals  are 
quite  clear,  but  the  mother  states  that  there  were  sores  on  the  latter  after  vaccination.  The  glands  in  both 
groins  are  large,  and  can  be  very  distinctly  felt. 

The  mother  is  rather  pale,  but  looks  healthy,  and  declares  she  has  always  been  so.  This  is  her  first  child. 

The  following  persons  were  vaccinated  from  the  preceding  case  on  February  7,  and  presented  on  May  16 
the  following  features : 

Case  1. — Female,  set.  17,  Ho.  6  in  Mr.  Hutchinson’s  first  series  ;  a  hearty,  robust,  plump  girl,  with  bright 
color.  Has,  in  a  horizontal  line,  three  vaccination  marks  on  the  left  arm,  the  outer  of  which  is  not  yet 
healed;  the  base  of  this  sore  is  very  slightly  thickened.  Mr.  Hutchinson  states  that  this  girl  has  been 
living  at  home  with  her  friends,  and  taking  her  medicine  very  irregularly. 

Case  2. — Male,  set.  18,  Ho.  10  in  Mr. Hutchinson’s  first  series.  A  dark-complexioned,  strumous-looking  lad. 
Has  three  cicatrices  on  his  left  arm,  which  present  nothing  different  from  recent  vaccination  marks.  There 
are  a  few  scattered  spots  of  acne  on  the  shoulders  and  upper  part  of  chest. 

Case  3. — Male,  tet  19.  A  liealthy-looking  lad.  Has  an  unhealed  ulcer,  larger  than  a  shilling  piece,  on 
the  right  arm,  resulting  from  vaccination.  The  sore  is  covered  by  a  crust,  which  is  disposed  to  scale 
slightly,  and  its  base  is  leathery.  Hoiking  else  can  be  detected. 

Mr.  Hutchinson  states  that  this  is  the  last  case  of  the  series  which  had  been  traced,  and  therefore  treat¬ 
ment  was  commenced  later  than  in  the  others.  He  also  informs  us  that  in  the  above  three  cases  the  vaccin¬ 
ation  sores  all  healed,  and  subsequently  ulceration  set  in  at  some  of  them,  which  continued  to  spread  slowly 
until  mercury  was  given,  when  in  about  ten  days  they  commenced  to  heal.  Black-wash  was  applied  locally. 
The  same  sequence  of  events  had  occurred  in  all  the  other  cases  of  this  group  that  we  had  seen. 

From  the  foregoing  account,  it  will  be  seen  that  neither  the  vaccinifer,  nor  any  of  the  three  cases  vaccin¬ 
ated  from  it,  presented  any  symptoms  of  constitutional  syphilis  at  the  time  of  our  examination.  But,  whilst 
in  Case  2  the  vaccination  sores  were  healed,  leaving  nothing  but  the  ordinary  scars,  in  Cases  1  and  3  there 
were  still  open  ulcers  at  the  site  of  the  vaccination  fourteen  weeks  after  its  performance.  These  ulcers 
were  of  a  suspicious  but  not  of  a  conclusive  character. 

Of  the  second  series  of  cases  reported  by  Mr.  Hutchinson  we  have  seen  the  vaccinifer  (Ho.  2),  and  three 
children  (cases  4,  5,  6),  who  were  vaccinated  from  it, 

Vaccinifer  (Ho.  2),  male,  set.  7  months.  Had  been  used  on  February  13  for  vaccinating  the  series  of  bases 
reported  by  Mr.  Hutchinson  on  May  9,  and  brought  under  his  observation  by  Mr.  Warren  Tay. 

This  child  is  hydrocephalic ;  its  head  is  universally  enlarged  ;  the  fontanelles  are  perhaps  more  open 
than  usual.  It  is  a  pallid  delicate-looking  child,  and  has  a  slight  herpetic  eruption  on  the  forehead,  but  is 
very  lively.  It  breathes  hard  through  the  nose  ;  the  mother  says  it  has  a  cold  and  is  teething.  There  is  a 
small  white  scar  at  the  anus,  as  if  from  an  ulceration.  The  glands  in  both  groins  axe  large  and  separate. 
On  the  right  are  five  vaccination  marks,  which  are  healed. 

The  mother  is  a  bright-complexioned,  healthy-looking  woman  and  has  never  suffered  from  illness.  This  is 
her  first  child.  Shelias  never  had  a  miscarriage,  or  discharge,  or  sore  nipples.  She  says  the  child  has 
been  occasionally  nursed  by  the  landlady  and  her  children  She  knows  that  one  of  these  was  ill,  and  was 
sent  into  the  country  for  its  health,  and  the  mother  had  attended  a  hospital,  but  -she  never  heard  what  was 
the  matter  with  either  of  them. 

The  father,  set.  36,  cabinet-maker,  is  a  spare  pale  man,  but  apparently  in  health;  he  has  worked  thirteen 
vears.in  the  same  situation.  He  denies  having  had  venereal  disease  of  any  kind,  and  readily  submitted  to 
examination  without  previous  preparation  ;  nothing  could  be  found  except  some  enlarged  separate  glands 
in  the  left  groin,  and  a  slight  wliite  scar  on  the  inside  of  the  cheek,  opposite  the  left  molar  tooth.  The  only 
illnesses  he  has  ever  had  are  measles  and  whooping-cough. 

The  following  cases,  which  had  been  vaccinated  from  this  vaccinifer  on  February  13,  presented  the  ap¬ 
pearances  detailed  below  on  May  16,  thirteen  weeks  afterwards  : 

Case  4.— E.  T. - ,  a  girl,  tet.  4$,  Ho.  2  in  Mr.  Hutchinson’s  seCond  series  of  cases,  a  pallid,  tbin, 

strumous-looking  child.  On  the  right  arm  are  two  sores  covered  by  crusts;  the  larger  of  these  has  a  cir¬ 
cumscribed  thickened  base,  which  is  superficial,  and  has  a  leathery  feel  when  compressed;  the  surface  of 


396 


Spurious  Vaccination:  Joseph  Jones ,  M.  1). 


this  is  disposed  to  scale.  The  glands  in  the  corresponding  axilla  are  enlarged.  There  is  a  scaly  eruption  ’ 
consisting  of  small,  circumscribed,  for  the  most  part  circular,  spots  of  a  colfee-color  at  the  back  ot  the 
neck,  the  lower  part  of  the  abdomen,  and  the  upper  and  outer  part  of  the  thighs,  with  a  general  scattered 
mottling  of  the  trunk,  on  its  anterior  surface  especially.  The  inguinal  and  post-cervical  glands  are  large 
and  indistinct.  Both  the  tonsils  are  excavated,  but  not  now  ulcerated. 

Case  5 _ A.  E.  T - ,  ahoy,  set.  18  months,  male,  No.  1  in  Mr.  Hutchinson’s  series,  a  fat,  well-grown. 

hearty-looking  child.  On  the  left  arm  are  two  dusky-colored  marks  of  vaccination,  which  are  scaling  on 
the  surface,  but  not  ulcerated ;  these  have  a  thickened  base,  precisely  similar  to  the  preceding  case.  There 
is  a  general  mottling  of  the  trunk,  which  is  fading,  and  a  few  small  scaly  spots,  resembling  those  in  the 
foregoing  patient,  scattered  over  the  abdomen.  The  glands  in  each  groin  are  very  distinct.  There  is 
well-marked  ulceration  of  both  tonsils. 

The  mother  of  these  children  is  a  healthy-looking  woman ;  she  has  never  suffered  from  illness  ;  a  rigid 
eross-examination  failed  to  elicit  any  history  of  previous  syphilis  in  herself  or  either  of  her  children. 

Case  6. — W.  C— ,  set  10,  a  boy,  No.  3  in  Mr.  Hutchinson’s  second  series.  This  case  was  not  reported  at 
the  Medical  and  Chirurgical  Society.  A  spare  lad,  but  not  unhealthy  in  appearance  ;  his  mother  says  he 
has  lost  much  flesh  lately.  On  the  left  arm  the  cicatrices  of  vaccination  in  infancy  show  plainly,  aud  below 
these  are  two  large  sores  covered  with  crusts  with  well-defined,  thickened,  circumscribed  bases,  surrounded 
by  a  dusky  areola.  The  glands  in  the  corresponding  axilla  are  enlarged.  The  inguinal  and  post-cervical 
glands  are  very  perceptible  to  touch.  There  is  a  scaly  eruption,  for  the  most  part  in  small  annular 
patches,  over  the  trunk  and  limbs,  which  is  fading.  On  each  tonsil  is  a  deep,  vertical  ulcer,  with  a  gray, 
unhealthy  surface. 

The  mother  is  a  tall,  healthy-looking  woman  ;  she  has  never  had  any  serious  illness,  and  no  history  of 
previous  syphilis  in  herself  or  her  boy  can  be  obtained.  These  three  cases  were  vaccinated  on  the  same 
day,  and  the  ulcers  resulting  have  never  healed,  but  have  slowly  increased  in  size.  There  has  been  no 
treatment  in  any  of  them. 

In  our  opinion,  these  three  cases  present  unequivocal  evidence  of  constitutional  syphilis,  and  we  see  no 
reason  to  doubt,  from  the  appearances  presented  by  the  arms  and  from  the  history  of  the  cases,  that  the 
disease  had  been  conveyed  by  vaccination. 

As  to  the  method  in  which  vaccination  was  performed  in  these  cases,  and  the  character  of  the  fluid  inocu¬ 
lated,  whether  lymph,  blood,  or  both,  we  could  obtain  no  satisfactory  evidence;  and  with  regard  to  this 
question,  we  may  refer  to  the  remarks  made  by  Mr,  Hutchinson  in  his' paper,  where  such  facts  as  could  be 
elicited  are  recorded,  [Signed]  SAMUEL  WILKS, 

WM.  S.  SAVORY, 

GEO.  G.  GA  SCO  YEN, 
THOMAS  SMITH. 

The  following  case  was  shown  to  Dr.  Wilks  by  Mr.  Hutchinson,  on  May  19,  being  one  of  the  same  series 

Case  4. — Female,  set.  14.  No.  4  in  Mr.  Hutchinson’s  second  series.  There  was  a  round  red  sore  on  the 
arm,  raised  and  granulating.  Over  the  body  and  arms  was  a  well-marked  eruption  of  bronze-colored, 
scaly,  raised,  spots.  The  tonsils  were  swollen  and  slightly  ulcerated. 

[Signed]  SAMUEL  WILKS. 


SECOND  REPORT  ON  CASES  OF  VACCINO-SYPH1LIS. 

The  following  cases— belonging  to  the  first  series  reported  by  Mr.  Hutchinson  on  April  25 — were  seen  by 
us  on  August  1,  1871,  with  Mr.  Hutchinson  and  the  medical  attendant.  They  were  vaccinated  February  7 
from  vaccinifer  No.  1  ;  all  have  been,  and  still  are,  taking  mercury;  in  one  or  two  of  them  the  gums  are 
slightly  reddened.  They  belong  to  the  group  first  described  in  the  previous  report,  so  that  eight  of  that 
series  have  been  seen  by  the  committee . 

Case  1. — C.  R - ,  female,  set.  26,  No.  5  in  Mr.  Hutchinson’s  first  series.  -A  plump,  robust  woman,  with 

fresh  color,  is  apparently  in  perfect  health.  On  the  left  arm  are  the  cicatrices  of  three  vaccination  marks, 
which  are  quite  healed  ;  they  are  of  a  dusky  brown  color,  but  opinions  differ  as  to  whether  they  are  darker 
than  usual.  There  are  three  or  four  scattered  spots  of  acne  on  the  chest  and  back.  The  throat  is  sound. 
Mr.  Hutchinson  states  that  this  patient  has  never  had  a  characteristic  rash. 

Case  2. — M.  J.  L - .  female,  set.  18,  No.  4  in  Mr.  Hutchinson’s  first  series.  A  pale,  delicate-looking 

girl,  but  does  not  appear  to  be  out  of  health.  There  are  three  cicatrices  from  vaccination  in  a  horizontal 
line  on  the  right  arm,  which  are  quite  healed  and  somewhat  dusky  in  color.  The  glands  beneath  and  be¬ 
hind  the  angle  of  the  left  lower  jaw  are  enlarged,  forming  a  mass  which  extends  over  the  parotid  region  and 
downward  into  the  neck.  There  is  one  enlarged  gland  at  the  back  of  the  neck  on  the  right  side.  In  each 
tonsil  is  a  vertical,  excavated,  unhealthy-looking  ulcer.  At  the  bend  of  the  right  elbow  is  one  red  spot 
which  is  scaling,  and  another  less  distinct  on  the  left  arm  at  the  same  situation . 

Case  3.— C.  T - ,  male  set.  20,  No.  8  in  Mr.  Hutchinson’s  first  series.  A  short  but  rather  thick-set  man 

of  fair  complexion  ;  looks,  and  says  he  is,  quite  well.  On  the  left  arm  is  one  dusky-colored  cicatrix  of  vac¬ 
cination,  quite  healed.  A  few  small  spots  of  acne  are  scattered  over  the  upper  part  of  the  chest.  The 
fauces  are  slightly  congested,  but  there  is  no  ulceration. 

Case  4. — H.  H - ,  male,  set.  22. — No.  9  in  Mr.  Hutchinson’s  first  series.  A  very  fair  man,  with  a  par' 

ticularly  clear,  white  skin  and  bright  color,  appears  to  be  in  perfect  health.  On  the  left  arm  is  one  dark- 
colored  cicatrix  from  vaccination  quite  healed.  The  tonsils  are  large  and  red,  but  not  ulcerated.  In  the 
centre  of  the  back,  below  the  scapulae,  is  a  superficial  patch  somewhat  coppery  in  color,  desquamating 
slightly  and  fading  off. 

Case  5.  — W.  W  ,  male,  aet.  18,  No.  10  in  Mr.  Hutchinson’s  first  series.  A  dark-complexioned  man. 
spare  and  short ;  looks  to  be  in  general  health.  On  the  left  arm  is  a  deep-colored  vaccination  scar,  not 
raised  and  quite  healed.  A  few  spots  of  acne  are  scattered  over  the  shoulders.  The  fauces  are  a  little 
congested,  but  not  ulcerated.  WM.  S.  SAVORY, 

GEORGE  G  GASCOYEN. 


On  July  25,  1871,  in  company  with  Mr.  Hutchinson  and  the  gentleman  who  vaccinated  the  cases  reported 
in  the  first  series,  I  visited  a  large  business  establishment  in  order  to  examine  several  of  the  persons  who 
had  been  vaccinated  from  vaccinifer  No.  1,  already  reported  on. 

No.  1. — J.  L - ,  a  girl,  jet.  18,  No.  4  in  Mr.  Hutchinson’s  first  series.  She  showed  three  vaccine  marks 

on  one  arm  of  a  brownish  color.  On  her  body  and  arms  there  were  a  few,  small,  copper-colored,  scalv 
blotches.  I  counted  about  a  dozen  in  all.  Her  throat  showed  a  deep  excavated  ulcer  on  the  right  tonsil,  and 


Spurious  Vaccination :  Joseph  Jones,  M.  D. 


397 


on  the  left  two  or  three  smaller  and  more  superficial  ulcers.  The  posterior  cervical  glands  were  enlarged, 
and  on  the  left  side  under  the  jaw  there  was  a  circumscribed  lymphatic  gland  much  enlarged. 

No.  2. — C.  R - ,  acook,  set-  24,  No.  5  in  Mr.  Hutchinson’s  first  series.  On  her  arm  there  were  two  vac¬ 

cination  marks  ;  these  presented  no  remarkable  appearance.  On  examining  the  neck  and  body  there  were 
seen  a  few  very  faint  blotches.  These  would  have  been  scarcely  observed  had  they  not  been  pointed  out  as 
the  traces  of  what  was  said  to  have  been  a  very  evident  eruption  a  few  days  before.  There  was  nothing 
worthy  of  notice  in  this  case. 

No.  3. — 0  T - ,  a  young  man,  set.  20,  No.  8  in  Mr.  Hutchinson’s  first  series.  On  one  arm  was  the  cica¬ 

trix  of  the  vaccination,  only  one  place  having  taken.  This  was  of  a  red  color,  not  |very  dark,  and  felt 
hard  when  pinched  from  side  to  side.  Outlie  body  and  arms,  and  more  especially  on  the  abdomen,  there 
was  seen  a  general  mottling  or  staining  of  the  skin.  The  rash  was  slightly  darker  than  the  surrounding 
healthy  surface,  but  was  not  raised.  This  was  said  to  he  the  remains  of  a  rash  which  was  well  marked  a 
few  days  previously.  No  other  symptoms. 

No.  4.— W.  W— — ,  a,  young  man,  set.  18,  No.  10  in  Mr.  Hutchinson’s  first  series.  He  had  a  rash  similar 
to  that  seen  in  the  preceding  case,  but  more  defined.  All  over  the  body  and  shoulders  there  were  distinctly 
defined  blotches  of  a  brownish  color.  These  were  evidently  the  remains  of  a  fadieg  rash,  which  was  said 
to  have  been  very  distinct.  The  remains  of  a  nearly  healed  ulcer  in  the  throat  were  to  be  seen . 

No.  5. — H.  H— — ,  a  young  man,  set.  22,  No.  9  in  Mr.  Hutchinson’s  first  series.  Covered  with  a  rash  re¬ 
sembling  that  seen  in  the  preceding  case,  but  still  more  marked.  On  passing  the  hand  over  the  surface  it 
felt  somewhat  raised  as  if  disposed  to  be  lichenous.  The  tonsils  were  much  enlarged,  red,  and  injected. 
This  enlargement  is  probably  of  old  standing. 

In  the  last  three  cases  the  eruption  might  be  styled  erythematous,  while  in  this  case  it  was  disposed  to 
be  also  papular.  SAMUEL  WILKS . 


These  cases  were  seen  by  members  of  the  committee  on  three  separate  occasions,  which  accounts  for  the 
differences  in  the  several  reports. 

When,  however,  the  history  of  the  patients  is  taken  into  consideration,  and  the  symptoms  presented  by 
them  at  different  periods  of  time,  we  can  entertain  but  little  doubt  that  they  have  been  the  subjects  of  con- 
stititutional  syphilis.  SAMUEL  WILKS, 

WM.  S.  SAYORT, 

GEO.  G.  GASCOYEN. 


On  September  4,  1871,  I  saw  a  female,  set.  18,  No.  4  of  Mr.  Hutchinson’s  first  series.  She  had  a  large  and 
tender  swelling  on  the  left  side  of  the  neck,  beneath  the  angle  of  the  jaw.  There  was  a  large  excavated  ul¬ 
cer  on  the  right  tonsil ;  there  were  a  few  faintly  marked  scaly  copper-colored  spots  about  the  bead  of  the 
elbow.  On  the  right  arm  were  three  marks  of  vaccination  of  a  light  copper  color.  The  patient  complained 
of  pains  in  her  forehead.  She  seemed  to  be  in  good  general  health.  THOMAS  SMITH. 


I  entirely  agree  with  the  above  report,  so  far  as  it  applies  to  this  case,  which  was  the  only  one  of  this 
group  that  I  had  an  opportunity  of  examining.  THOMAS  SMITH. 


It  will  be  observed  that  in  the  series  of  vaccinations  reported  by  Mr. 
Hutchinson,  not  all  those  vaccination  from  the  same  children  contracted 
syphilis.  Mr.  Hutchinson  asks  whether  the  practice  followed  by  some 
vaccinators  of  allowing-  the  vesicle  to  drain  after  its  first  contents  have 
been  exhausted,  and  using  the  weepings,  necessarily  mixed  with  the  consti¬ 
tuents  of  the  blood,  for  vaccination,  may  not  account  for  the  fact  that 
those  first  vaccinated  in  the  series  escapad  the  contagion  of  syphilis. 

Evidence  has  been  recorded  to  show  that  direct  inoculation  of  blood 
from  a  syphilitic  patient,  may  propagate  primary  syphilis. 

In  odder  to  avoid  the  catastrophe  of  communicating  syphilis  by  vaccina¬ 
tion  the  following  precautions  have  been  recommended  : 

1.  A  clean  lancet  should  be  used. 

2.  In  selecting  lymph  avoid  first  children,  and  those  where  family  history 
is  not  well  known  to  the  physician. 

3.  Exercise  the  most  scrupulous  care  in  the  performance  of  vaccination 

4.  The  lymph  should  be  taken  from  the  vesicle  not  later  than  the  eighth 
day. 

5.  The  lymph  only  should  be  taken,  and  it  should  be  free  from  the  ad¬ 
mixture  of  blood  or  other  secretions. 

6.  The  lymph  should  be  always  taken  from  a  healthy  subject. 

7..  Whenever  the  surgeon  is  not  fully  and  thoroughly  satisfied  of  the 
humanized  virus  at  his  command,  he  should  use  virus  derived  directly  from 
the  cow. 

A  graver  question  is  involved  than  even  the  possibility  of  syphilitic  in¬ 
fection,  and  one  which  threatens  the  safety  of  the  entire  community, 
namely  the  avoidance  and  even  forcible  resistance  of  all  vaccination  and  the 


398 


Spurious  Vaccination :  Joseph  Jones,  M.  D. 


defeat  of  all  laws  devised  to  protect  the  people  from  the  ravages  of  small¬ 
pox,  on  account  of  the  occurrence  of  such  isolated  cases,  as  those  of  the 
outbreak  at  Rivalta,  and  those  reported  by  Mr.  Hutchinson. 

The  object  of  vaccination  is  to  produce  a  real  and  absolute  disease;  and 
no  precaution  should  be  regarded  as  too  minute  and  trifling  which  is  cal¬ 
culated  to  insure  the  perfect  attainment  of  this  end;  the  vaccine  disease  is 
not  natural  to  man,  it  is  planted  on  a  soil  foreign  to  its  existence  ;  ahd  there¬ 
fore  it  requires  constant  watchfulness  and  judicious  cultivation  to  restrain 
all  conditions  or  tendencies  to  deterioration. 

If  under  the  best  possible  selection,  and  with  the  utmost  care  in  cultiva¬ 
tion,  the  vaccine  virus  loses  energy  as  its  human  transmissions  become 
more  and  more  numerous,  it  follows  logically  that,  from  time  to  time, 
new  sources  of  primary  supply  should  be  sought  for  and  opened. 

We  have  recorded  the  essential  facts  in  the  histor}7  of  the  cow-pox  in 
various  countries,  and  the  medical  profession  should  be  always  on  the  alert 
to  discover  spontaneous  cow-pox,  and  should  ever  be  ready  to  introduce 
new  supplies  of  cow-pox  matter. 

MODIFIED,  OR  LACTO-VARIOLOUS  INOCULATION. 

Docter  Basil  Thiele,  conceived  the  idea  of  mixing  the  virus  of  small-pox 
with  milk ;  and  in  1839  thus  described  this  process. 

Small-pox  matter  was  preserved  for  ten  days  between  glasses,  closed 
with  wax ;  then  after  having  diluted  the  matter  with  warm  cow’s  milk,  in¬ 
oculation  was  practiced  as  with  ordinary  vaccine. 

Dr.  Thiele  stated  that  the  pustules  obtained  by  means  of  this  mixture 
are  much  better  marked  than  in  ordinary  cases,  but  after  about  ten  trans¬ 
missions,  they  end  by  presenting  the  characteristics  of  true  vaccine  when, 
however,  care  has  been  taken  at  each  transmission  to  mix  the  virus  of  va¬ 
riola  with  a  small  quantity  of  milk  taken  directly  from  the  cow. 

M.  Bracuet,  at  Lyons,  and  Robert,  at  Marseilles,  claimed  to  have  per¬ 
formed  similar  experiments  about  the  same  time. 

The  theory  which  underlies  this  practice  appears  to  be,  that  variola  has 
passed  from  man  to  the  cow,  and  that  during  this  passage  it  has  undergone 
that  modification  which  makes  of  it  vaccine;  the  changes  which  takes 
place  in  the  virus  of  variola  can  also  be  produced  by  a  drop  of  milk  in  the 
open  air. 

Dr.  Descieux  of  Monfort  l’Amanry,  was  attending  a  woman  attacked 
with  variola;  three  of  her  children  were  around  her;  two  had  not  been 
vaccinated  ;  having  at  the  time  no  vaccine  matter,  he  made  a  mixture  of 
milk  and  variolous  matter,  with  which  he  inoculated  the  children  making 
four  incisions  in  each  arm.  The  sores  at  the  points  of  insertion  occurred 
as  usual  and  followed  the  course  customarily  observed  ;  but  on  the  eighth 
day  one  of  these  children  was  taken  with  fever,  and  three  days  later  from 
twenty-five  to  thirty  elevations  appeared  over  its  body.  The  other  child 
showed  only  the  sores  of  insertion,  besides  which  on  the  eleventh  day,  five 
or  six  supernumary  points  not  far  removed  from  the  spots  where  the  virus 
had  been  inserted  made  their  appearance. 

Notwithstanding  this  second  eruption,  M.  Descieux  still  remained  un¬ 
decided ;  on  the  eighth  day  he  again  took  virus  from  the  last  child  and 
transmitted  it  to  three  others.  This  inoculation  cleared  up  all  his  doubts  ; 
the  newly  inoculated  being  all  three  seized  witlqwell  defined  although  mild 
attacks  of  variola.  In  one,  the  general  eruption  made  its  appearance  on 
the  seventh  day,  and  in  the  two  others  on  the  eleventh. 

A  midwife  inoculated  five  infants  with  lacto-variolous  matter;  one  of 
those  three  had  a  complete,  though  rather  mild  attack  of  variola,  and  the 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


399 


two  others  who  were  barely  two  months  old,  had  confluent  smali-pox,  and 
their  lives  were  in  danger. 

A  final  proof  of  the  small  efficacy  which  milk  has  in  modifying  variola, 
was  afforded  by  the  fact  that  these  experiments  gave  rise  to  an  epidemic  of 
small-pox,  which  affected  six  vaccinated  persons. 

The  epidemic  was  not  at  an  end,  at  the  time  when  M.  Descieux,  wrote  the 
preceding  interesting  details. 

M.  Laufranclii,  sanitary  officer  at  Guitera  (Canton  of  Licaro  District  of 
Ajaccio),  and  physician  to  the  Canton,  had  to  contend,  in  1854,  with  an  epi¬ 
demic  of  confluent  variola,  and  conceived  the  idea  of  testing  on  his  son  a 
mixture  of  variolous  matter  and  cream  from  cow’s  milk.  The  inoculation 
of  this  variolous  matter  and  cream,  resulted  in  the  formation  of  a  snmll 
scab  which  fell  off  or  became  indolent  on  the  third  or  fourth  day  ;  when  on 
the  sixteenth  or  seventeenth  day  a  well  pronounced  inflammation  mani¬ 
fested  itself  at  the  incision  :  fever  was  kindled,  and  variolous  pimples  exhibi¬ 
ted  themselves  in  divers  places  on  the  body,  to  the  number  of  seven  or 
eight.  The  fever  was  mild  in  character  and  the  child  recovered,  six  other 
children  of  the  parish  in  which  the  fatal  form  of  confluent  variola  was  pre¬ 
vailing,  were  subjected  to  the  same  mode  of  inoculation,  and  like  the  son  of 
M.  Lanfranchi*  had  a  benign  type  of  varioloid. 

If  the  disease  produced  was  varioloid,  it  was  of  course  contagious,  and 
no  special  advance  was  made  on  the  old  method  of  inoculation ,  which  we 
have  shown,  was  a  comparative  mild  and  harmless  operation,  often  attended 
with  but  slight  fever  and  few  pustules,  and  causing  death  when  properly 
treated  in  a  proportion tof  not  more  than  one  in  600  cases.! 

Dr.  0.  H.  Tebault,  practiced  “Modified  Inoculation,”  or  the  engrafting  of 
-l  equal  parts  of  cow’s  milk  and  variolous  matter  taken  from  the  pock  in 
the  vesicular  stage,”  in  October,  1864,  upon  some  thirty  Confederate  soldiers 
in  the  Ocmulge  Hospital,  at  Macon,  Georgia. 

Dr.  Tebault  states  that  he  “engrafted  one  soldier  after  another  with  the 
modified  lymph,  until  thirty-odd  had  swelled  the  list  of  my  experiments. 
Of  thirty-five  persons  thus  successfully  inoculated,  there  only  exhibited  a 
few  additional  pocks,  in  no  case  more  than  six  in  addition  to  the  seat  of 
puncture.”  • 

“Additional  pocks”  are  not  characteristic  of  the  vaccine  disease ;  but  they 
are  characteristic  of  inoculated  small-pox.  • 

By  the  stringent  orders  of  Surgeon  General  S.  P.  Moore,  universal  vac¬ 
cination  had  been  and  was  practiced  by  the  medical  officers  of  the  Con¬ 
federate  Army  ;  and  a  military  hospital  subject  to  this  rigid  rule  was  not 
the  most  favorable  position  to  test  the  contagious  or  non-contagious  char¬ 
acter  of  the  disease  induced  by  “modified  inoculation.” 

The  question  was  rendered  still  more  complicated  by  the  prevalence  of 
small-pox  m  Macon,  and  the  transferring  of  small  pox  cases  occurring 
amongst  the  Confererate  troops  to  the  small  pox  encampment  or  tent  hos¬ 
pital  three  miles  from  Vineville,  under  the  direction  of  Assistant  Surgeon 
L.  Carter  (at  that  time  in  the  service  of  the  Confederacy). 

Dr.  Tebault  states  that“  at  the  encampment  above  mentioned,  this  modi¬ 
fied  inoculation  was  in  general  use,  vaccination  being  entirely  ignored.  It 
was-  practiced,  I  believe,  previous  to  the  date  of  my  own  experiments, 
though  unknown  to  me  at  the  time.  To  this  station  all  cases  of  variola  or 
varioloid  occurring  at  any  of  the  post  hospitals,  were  immediately  sent 
for  treatment.” 

*  Revue  Medico-Cliirurgicale,  No,  13,  p.  543. 

tModitied  Inoculation  by  C.  H.  Tebault  M.  D.  New  Orleans  Medical  and  Surgical  Journal,  July,  1866 


400 


Spurious  Vaccination :  Joseph  Jones ,  M.  J). 


Dr.  Tebault,  writing  in  18G6,  expressed  tlie  liope  that  “  Dr.  Carter  will 
find  an  early  occasion  to  make  known  liis  very  extended  experience  in  the 
premises.” 

During  my  investigate  ns  upon  hospital  gangrene  in  the  Confederate 
Army  at  the  Empire  Hospital,  in  1SG4,  I  frequently  visited  the  small  pox 
tent  hospital  on  the  outskirts  of  Yineville,  and  witnessed  the  devotion  of 
Dr.  Carter  to  the  small-pox  patients.  I  also  conducted  investigations  upon 
the  changes  of  the  urine  in  variola  and  varioloid,  and  performed  post  mor¬ 
tem  examinations. 

I  also  corresponded  with  Dr.  Carter  on  the  subject  of  inoculation,  after 
the  war,  and  his  testimony  was  to  the  effect,  that  he  did  not  mix  milk 
with  the  variolous  matter,  but  employed  the  clear  lymph  from  the  pocks 
before  the  formation  of  pus. 

He  appeared  to  attribute  the  mildness  of  the  resulting  variola  to  the 
employment  of  the  variolous  lymph  before  the  formation  of  pus. 

As  therefore  there  are  facts  to  show  that  the  disease  excited  by  inocu¬ 
lating  the  mixture  of  milk  and  variolous  matter  is  essentially  varioloid 
and  capable  of  producing  small  pox  in  the  unprotected,  we  must  therefore 
discard  lacto-variolous,  (modified)  inoculation,  for  the  same  reasons  that 
the  profession  has  abandoned  small-pox  inoculation. 

Inoculation  whether  performed  with  pure  small-pox  matter,  or  with  a 
mixture  of  variolous  matter  with  cream  or  milk,  induces  a  comparatively 
mild,  and  harmless  disease  to  the  individual ;  but  it  keeps  alive  the  con- 
tagium  of  small-pox,  and  involves  the  health  and  lives  of  all  unprotected 
persons  in  contact.  *  , 

RETRO- VACCINATION. 

Retro-vaccination,  or  the  inoculation  of  cows  with  vaccine  lymph  that 
has  been  passed  through  the  human  body  has  been  performed  inumerable 
times  by  various  observers,  with  very  variable  success. 

Ceely  made  various  discriminative  experiments,  and  found  that  whatever 
the  source  of  the  lymph,  and  whatever  its  age,  if  it  were  only  good  lymph, 
it  succeeded  equally  often,  and  excited  equally  perfect  and  productive  vesi¬ 
cles. 

The  most  conflicting  statements,  however,  have  been  made,  as  to  the 
facility  with  which  cows  may  be  infected  with  humanized  lymph.  Accord¬ 
ing  to  Heim*  Hering  and  Hausmann,  the  experiment  is  only  rarely  suc¬ 
cessful,  perhaps  once  out  of  ten  or  a  dozen  trials ;  Fiard  met  with  but 
six  or  seven  very  doubtful  successes  in  seventy  experiments ;  Viborg  and 
Retta  were  unable  to  succeed;  on  the  other  hand,  Caque,  at  Rheims, 
Husson  and  Tenier,  at  Paris  and  Versailles,  Sacco,  at  Milan,  and  Hill  wag, 
at  Eutin,  in  the  early  days  of  vaccination,  and  more  lately,  Neumann,  at 
Utrecht,  Billing,  at  Stockholm  fin  1832),  Lentin,  in  Weimare  in  1835), 
Prinz,  at  Dre  sden  (in  1838),  Messrs.  Ceely,  Chauveau  and  others  have 
succeeded. 

Dr.  Edward  C.  Seaton  in  his  valuable  hand-book  of  vaccination  (p.  96) 
states  that  “when  active  lymph,  such  as  passes  from  arm  to  arm  with  the 
greatest  facility,  is  passed  through  the  cow,  and  at  once  vaccinated  back, 
it  yet  retains  so  much  of  its  humanization  that  it  is  not  able  to  fail  like 
primary  cow-lymph,  but  will  be  found  also  to  have  lost  so  much  of  its 
humanization  that  on  its  return  to  the  human  subject,  it  takes  effect  less 
kindly;  papulation  is  usually  retarded,  and  though  the  vaccination  may 
obtain  maturity  at  the  ordinary  average  period,  the  completion  of  the 
maturation  is  often  postponed.  The  vesicles  are  often  smaller  and  the 
disease  not  really  so  well  developed  as  the  stock  from  which  the  lymph 
was  derived.  Two,  three,  four,  or  several  removes  are  necessary  to  give  it 
the  same  activity  as  it  had  before  it  was  transferred. 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


401 


VARIOLATION  OF  THE  COW;  OR  PRODUCTION  OF  VACCINE 
BY  INOCULATION  WITH  THE  LYMPH  OF  HUMAN  VA¬ 
RIOLA. 

The  records  of  medicine  establish  beyond  the  shadow  of  a  doubt  that  it 
is  possible  to  produce  vaccine  in  the  cow  by  small-pox  inoculation  ;  but  the 
operation  is  one  of  very  considerable  difficulty  ;  for  one  case  in  which  the 
inoculation  succeeds,  it  will  fail  in  at  least  a  dozen. 

The  earliest  efforts  at  the  inoculation  of  the  cow  with  small-pox  failed  • 
Jenner  himself  did  not  perform  any  inoculations  of  cattle  with  the  lymph 
of  human  variola;  but  as  early  as  1801,  Gasner,  of  Gunsbury,  by  inocula¬ 
ting  eleven  cows  with  small  pox  matter  produced  on  one  of  them  vesicles 
from  which  he  was  able  to  inoculate  four  children  ;  these  children  developed 
the  ordinary  phenomena  of  vaccination,  and,  with  lymph  from  them,  sev¬ 
enteen  other  children  were  similarly  infected. 

In  the  same  year  (1801)  Loy  demonstrated  the  production  of  the  vaccine 
disease  in  the  cow  from  horse-pox  (variolae  equiuae) 

Dr.  McMichael  stated  to  the  Itoyal  College  of  Physicians  in  1828,  that  in 
Egypt  it  had  been  discovered  by  some  medical  men  that  tine,  active  vaccine 
virus  might  be  produced  by  inoculating  the  cow  with  small-pox  from  the 
human  body,  and  that  several  children  had  been  vaccinated  with  complete 
success  with  the  lymph  thus  generated.  (Report  of  the  Vaccination  See- 
tipn  of  Prov.  Med.  and  Surg.  Assoc.,  1839,  p.  24.) 

Dr.  Sunderland,  of  Barmen,  in  1830,  infected  cows  with  the  contagion  of 
variola,  by  enveloping  them  in  blankets  taken  from  the  bed  of  a  patient 
who  had  died  of  small-pox,  and  by  hanging  such  blankets  around  the  head 
of  the  animal,  so  that  they  might  breathe  the  effluvia  arising  from  them. 

The  result,  according  to  the  statement  of  Dr.  Sunderland,  was  that  in  a 
few  days  the  cows  manifested  the  symptoms  of  cow-pox,  and  lymph  taken 
from  them  produced  genuine  vaccine  vesicles  in  the  human  subject.  (Hufe- 
land’s  Journal,  January,  1831.) 

Similar  attempts  to  infect  cows  directly  by  the  repetition  of  Sunder¬ 
land’s  experiments,  as  those  of  Mr.  Ceely,  (1)  in  England,  Mr.  Macpherson, 
in  India,  and  by  Mr.  Lamb,  (2)  at  the  veterinary  school  at  All'or,  at  Ber¬ 
lin,  Weimar,  Bugen  Dresden,  Kason,  Utreteh  and  Stockholm,  were  unsuc¬ 
cessful. 

In  183G,  Dr.  Thiele,  of  Kasan,  after  similar  fruitless  attempts  to  infect 
the  cow  by  inoculation  of  the  variolous  virus,  succeeded  in  producing  the 
genuine  vaccine  disease.  From  this  Dr.  Thiele  raised  a  stock  of  lymph  for 
human  vaccinations,  which  at  the  time  his  account  was  published,  had 
gone  through  seventy-five  transmissions,  and  been  employed  in  the  vac¬ 
cination  of  more  than  3000  subjects,  many  of  whom  had  had  their  security 
against  small-pox,  tested  by  inoculation,  and  by  the  closest  exposure  to 
the  infection  of  that  disease. 

Dr.  Thiele  on  various  occasions  afterwards  succeeded  in  producing  cow- 
pox  in  cows  by  variolous  inoculation,  and  he  attributes  much  of  his  latter 
success  after  so  many  early  failures,  to  the  precaution  he  takes  in  selecting 
the  animals  and  in  the  mode  of  conducting  the  experiments. 

Dr.  Thiele  directs  that  the  cows  should  be  selected  from  four  to  six  years 
old,  which  have  recently  calved,  and  if  possible  which  have  white  or  fair 
teats;  they  should  be  kept  at  a  uniform  temperature  (15°  R.);  the  inocula¬ 
tions  should  be  performed  at  the  base  of  the  udder,  out  of  the  way  of  lick¬ 
ing,  the  udder  being  first  shaven ;  and  the  variolous  lymph  should  be  in  a 
clear  limpid  state. 


(1.)  Trans.  Prov.  Med.  and  Surg.  Assoc. ,  vol,  8,  p.  380. 

(2.)  Trans.  Med.  and  Pliys.  Society  of  Calcutta,  vol.  6  and  vol.  8. 


402 


v 

Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


Mr.  Ceely,  of  Aylesbur^,  succeeded  in  February,  1839,  in  producing 
vaccine  vesicles  in  two  sturks,  by  inoculation  with  variolous  lymph,  and 
in  thus  establishing  lymph-stocks  which  passed  at  once  into  extensive  use, 
so  that,  in  a  few  months,  more  than  2000  children  had  been  vaccinated 
from  them.  In  many  of  these  subjects  the  protective  value  of  the  Variola- 
vaccine  lymph  was  tested  by  variolous  inoculation  by  Mr.  Ceely  himself  at 
various  periods  after  the  vaccination;  no  constitutional  affection  was  pro¬ 
duced  thereby  in  any  case  and  the  local  results  resembled  in  every  respect 
those  recorded  by  Willanas  having  attended  the  test  inoculations  practiced 
in  the  early  days  of  vaccinatien.  The  experiments  were  made  on  this  oc¬ 
casion  on  three  animals,  and  succeeded  on  two  ;  but  he  states  that  he  had 
many  times  failed  to  variolate  the  cow  at  different  seasons  and  under  vary- 
ing  circumstances  by  precisely,  or  pretty  nearly  the  same  modes  of  opera¬ 
ting  as  were  successful  in  these  instances.  (Trans.  Prov.  Med.  and  Surg. 
Assoc,  vol.  8,  pp.  379-402.) 

Mr.  Ceely  draws  especial  attention  to  the  fact,  that  the  transmission  of 
the  disease,  thus  originated,  from  the  cow  to  the  human  subject  was  a 
matter  of  some  difficulty.  Out  of  twenty  punctures  made  from  his  first 
cow,  only  six  vesicles  were  obtained,  and  they  appeared  tardily;  he  de¬ 
scribes  the  vaccine  as  fine  and  “pearl  like.”  Out  of  sixteen  punctures,  again 
made  from  his  second  cow,  only  seven  vesicles  were  obtained.  The 
areola  did  not  appear  until  from  the  tenth  to  the  twelfth  day.  In  this 
difficulty  ot  transmission  Mr.  Ceely  recognises  phenomena  similar  to  those 
.  observable  in  vaccinating  from  primary  or  natural  cow-pox.  Subsequent 
human  generations  were  effected  more  readily  ;  but  in  some  instances  the 
difficulties  were  not  completely  overcome,  even  in  the  second  removes.  In 
the  subsequent  removes  a  marked  experiment  was  observed  in  the  develop¬ 
ment  of  the  vesicles,  and  the  active  manifestation  of  the  primary  and  sec¬ 
ondary  symptoms  were  not  less  apparent  than  in  the  use  of  natural  lymph 
under  corresponding  circumstances. 

Mr.  Badcock,  in  Deeember,  1840,  “succeded  in  variolating  a  cow  at 
Brighton,  and  deriving  thereform  a  stock  of  genuine  vaccine  lymph.  (A 
Detail  of  Experiments  Confirming  the  Power  of  Cow-pox,  etc). 

Mr.  Badcock,  from  1840  to  1807,  has  by  inoculation  of  cows  with  the 
lymph  of  human  variola  raised  stocks  of  vaccine  lymph  for  use  on  no  fewer 
than  thirty-seven  separate  occasions.  Every  one  of  these  thirty-seven  suc¬ 
cessful  experiments  was  the  result  of  the  direct  inoculation  of  the  animal 
with  lymph  taken  from  a  human  subject  affected  with  variola;  that  no 
case  is  included  in  which  lymph  taken  from  a  cow  that  had  been  variolated 
was  used  to  inoculate  other  cows. 

Dr.  Edward  C.  Seaton  states  that  the  lymph  thus  obtained  by  Mr.  Bad¬ 
cock,  is  now  (1868)  largely  employed ;  it  lias  been  supplied  to  many 
hundreds  of  practitioners,  and  very  many  thousands  of  children  have  been 
vaccinated  with  it. 

It  is  worthy  of  note,  however,  as  illustrating  the  difficulty  attendant  on 
the  production  of  vaccinia  in  the  cow  by  variolous  inoculation,  that  these 
thirty-seven  successes  represent  but  seven  per  cent  of  the  experiments 
undertaken  by  Mr.  Badcock  ;  to  obtain  them,  he  had  to  perform  between 
five  and  six  hundred  variolous  inoculations. 

There  is  a  large  amount  of  medical  testimony  to  show  that  the  lymph 
obtained  by  Mr.  Badcock,  is  equal  in  activity  and  protective  power  to  that 
of  the  early  human  generations  from  natural  cow-pox. 

In  1852,  Mr.  Ceely’s  experiment  were  repeated  in  America  by  Dr.  Adams, 
of  Waltham,  and  Dr.  Putnam,  of  Boston,  who  were  able  in  consequence  to 
“furnish  the  city  and  neighborhood  of  Boston  with  the  vaccine  matter 
used  there  since  that  period.” 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


403 


Dr.  Leonhard  Voight,*  superintendent  of  vaccination  at  Hamburg,  has 
recently  succeded  in  inoculating  cows  with  human  small-pox  matter  ;  his 
results,  however,  do  not  possess  the  value  which  attaches  to  those  obtained 
by  Thiel]  Ceely  and  Badcock,  inasmuch  as  he  performed  vaccination  sim- 
ultanous  with  the  variolous  inoculation. 

We  cannot  admit  that  the  experiments  at  Lyons  and  those  of  M.  Chau- 
veau,  show  “that  it  is  a  delusion  to  suppose  that  the  inoculation  of  cows 
with  variola  has  ever  produced  in  that  animal  real  cow  pox;  for  in  fact  it 
produces  in  the  cow  real  small-pox  and  nothing  else.” 

The  experiments  have  been  too  few  to  warrant  this  wide  inference;  at 
the  same  time  it  may  be  admitted  that  the  local  sores  produced  by  the 
small-pox  matter  may  have  been  capable  of  propagating  small-pox  when 
inoculated  into  the  human  being. 

We  cannot  admit  that  the  hundreds  of  practitioners  who  in  England 
have  been  using  Ceely’s  and  Badcock’s  lymph,  during  the  past  forty-four 
years  have  not  been  vaccinating  as  they  supposed,  but  actually  uncon¬ 
sciously  variolating  their  patients — that  they  have  in  fact  been  making 
their  patients  so  many  foci  of  variolous  infection. 


ANIMAL  VACCINATION. 

By  the  term  “Animal  Vaccination”  is  meant  the  employment  for  the 
vaccination  of  the  human  subject  of  the  virus  of  cow-pox,  as  propagated 
upon  a  succession  of  calves  or  heifers,  the  original  virus  having  been  de¬ 
rived  from  pocks  upon  the  cow  spontaneously  affected  with  the  natural 
disease. 

The  practice  of  animal  vaccination,  as  now  followed  in  Europe  and  vari¬ 
ous  parts  of  America,  originated  with  M.  Negri,  in  Naples,  who  was  the 
first  to  propagate  natural  cow-pox  by  successive  vaccinations  upon  the 
heifer. 

Shortly  after  the  introduction  of  vaccination  into  Italy,  Troja,  of  Naples, 
conceived  the  idea  of  taking  the  vaccine  virus  from  the  vaccinated  cow  for 
the  purpose  of  human  vaccination,  and  the  practice  was  preserved  by  him 
and  his  successors  during  many  years  for  the  benefit  of  the  upper  classes 
of  society.  On  the  death  of  Troja,  Galbiati  continued  it,  and,  although  in 
•310  these  vaccinations  were  prescribed,  yet,  in  the  same  year,  several  dis¬ 
tinguished  statesmen  availed  themselves  of  this  method  for  their  own 
children. 

Galbiati  was  followed  by  M.  Negri,  who  has  had  to  bear  the  brunt  of 
official  opposition  similar  to  that  offered  to  his  predecessors.  It  is  to  M. 
Negri  that  the  world  owes  the  practice  of  animal  vaccination.  Troja  and 
Galbiati  had  both  propagated  in  the  heifers  a  vaccine  disease  implanted 
upon  them  oaiginally  from  a  human  source.  In  fact,  they  practiced  retro- 
vaccination ,  the  result  of  which  was  propagated  through  a  series  of  animals. 

At  first,  M.  Negri  followed  in  their  steps,  and  after  a  time  ceased  to  prop¬ 
agate  the  virus  thus  obtained.  During  the  thirty -four  years  preceding 
1868,  that  he  has  presided  over  the  animal  vaccination  in  Naples,  he  has 
three  times  obtained  a  new  supply  of  virus  from  cases  of  natural  cow-pox, 
on  each  occasion  maintaining  the  supply  by  an  uninterrupted  succession  of 
inoculations  from  animal  to  animal. 

It  is  said  that  on  two  occasions  M.  Negri  availed  himself  of  natural  cow- 
pox  matter  obtained  in  Italy,  but  that  on  a  third  occasion,  in  1858,  in  which 
he  renewed  his  supply,  it  was  derived  from  London. 

*  Vaccine  and  variola  by  Dr.  Leonhard  Voight,  superintendent  of  vaccination  at  Hamburg.  Horth  Caro¬ 
lina  Medioal  Journal,  October,  1862  Ho.  10,  p,  083-412. j 


404 


Spurious  Vaccination :  Joseph  Jones ,  M.  I). 


So  thoroughly  have  all  the  prejudices  against  animal  vaccination  been 
cleared  away,  that  M.  Negri  vaccinated  from  the  heifer  in  the  course  of  a 
year  from  3,000  to  4,000  persons,  a  number  nearly  equal  to  the  annual 
births  that  take  place  at  Naples,  and  for  several  years  past,  M.  Birna,  of 
the  Italian  Army,  has  used  the  animal  vaccine  alone  for  his  regimental 
vaccinations  and  for  the  pupils  of  the  military  colleges. 

In  1864.  M.  Lanoix,  a  young  French  physician,  visited  Naples  in  order  to 
study  the  practice  of  animal  vaccination  as  pursued  there,  and  on  his  re¬ 
turn  brought  back  with  him  to  Paris  a  calf,  and  in  concert  with  M.  Cham- 
bon,  set  up  a  private  establishment  for  the  propagation  of  the  virus  irom 
calf  to  calf,  and  for  the  supply  of  animal  vaccination  in  Paris. 

In  his  report  on  vaccination  in  Franco  during  1864,  M.  Depaul,  in  the 
name  of  the  Academie  de  Mtklecine,  gave  an  account  of  the  observations 
made  in  Paris  upon  this  subject,  and  in  February,  1866,  the  French  Gov¬ 
ernment  placed  the  sum  of  6,000  francs  at  the  disposal  of  the  Academy  for 
the  purpose  of  experiment  in  the  matter.  A  commission  was  appointed, 
the  report  of  which  was  drawn  up  by  M.  Depaul,  the  Director  of  Vaccine. 
This  report  was  favorable  to  the  practice  of  animal  vaccination.  The 
commission,  however,  were  much  divided  in  opinion,  and  the  Academy  did 
not  recommend  that  the  practice  should  be  adopted.  At  first,  the  virus 
used  by  the  commission  was  that  in  use  by  MM.  Lanoix  aDd  Chambon,  and 
which  they  had  previously  obtained  from  Naples.  But,  after  four  trans¬ 
missions  of  the  virus  had  been  made,  a  new  source  of  virus  from  natural 
cow-pox  was  discovered  at  Baugency  (Loiret),  and  then  the  use  of  the 
Neapolitan  virus  was  abandoned,  and  this  new  and  undoubted  cow-pox 
virus  alone  employed. 

MM.  Lanoix  and  Chambon  also  adopted  the  use  of  this  virus  to  the  ex¬ 
clusion  of  that  they  had  before  employed,  and  having  in  the  autumn  of  the 
same  year  (1866)  met  with  another  case  of  natural  small-pox  at  St.  Maude, 
near  Paris,  they  introduced  this  lymph  also  into  their  practice  of  animal 
vaccination.  They  saw  no  advantage  in  keeping  these  two  lymphs  dis¬ 
tinct,  and  the  virus  they  have  employed  since  1866  to  the  present  time  is  a 
mixture  of  the  two  natural  sources  discovered  at  Baugency  and  St.  Maude. 
Whatever  the  origin  of  the  Neapolitan  virus  may  have  been,  therefore, 
there  can  be  no  question  that  the  inoculations  made  by  the  commission 
(after  the  first  four)  and  that  still  made  in  Paris  by  MM.  Lanoix  and 
Chambon,  were  transmissions  of  the  virus  of  a  cow-pox  of  spontanous 
origin. 

The  establishment  of  these  latter  gentlemen,  situated  in  the  centre  of 
Paris  ( Kue  Marsillen),  is  a  private  one.  They  bear  the  entire  expense  of 
it  and  make  a  charge  to  practitioners  and  others  to  whom  they  supply  virus. 
It  is  carried  on  like  that  of  M.  Negri,  at  Naples,  as  a  private  speculation. 

M.  Lanoix,  however,  has,  since  the  summer  of  1865,  held  ai*  appointment 
from  M.  Hassen,  the  Director  de  1’ Assistance  Publique,  for  the  weekly  per¬ 
formance  of  vaccinations  in  the  hospitals  of  Paris,  from  the  calves  which 
he  inoculates  week  by  week,  and  by  far  the  larger  part  of  the  vaccinations 
and  re-vaccinations  performed  in  these  establishments  is  done  in  this 
way. 

From  Paris  the  practice  of  animal  vaccination  has  extended  in  many 
children. 

In  February  1865,  it  was  introduced  into  Brussels,  by  Dr.  Warlomont. 

Animal  vaccination  has  been  inaugerated  in  Prussia  by  M.  Prosoroff. 
The  practice  was  introduced  into  Berlin,  by  M.  Pissin,  in  June,  1865,  and 
is  still  carried  on  there  as  a  private  speculation.  It  is  also  practiced  in  the 
same  way  in  Vienna. 


Spurious  Vaccinativn :  Joseph  Jones ,  M.  I). 


405 


The  practice  of  animal  vaccination  has  been  established  in  most  of  the 
capitols  of  Europe. 

Animal  vaccination  was  inaugurated  in  the  United  States  of  America,  in 
September,  1870,  by  Dr.  Henry  Austin  Martin,  M.  D.,  of  Boston,  Massa¬ 
chusetts.  (Boston  Medical  and  Surgical  Journal,  October,  20,  1870). 

Dr.  Martin  received  virus  by  letter  from  Professor  Depaul,  of  Paris,  and 
also  directly  through  his  agent,  who  returned  from  Paris,  to  Boston,  on 
the  twenty-third  of  September,  1870.  The  virus  brought  to  America,  by 
Dr.  Martin  was,  from  the  258th,  259th,  and  260th,  animal  of  DepauTs  series, 
beginning  with  the  heifer  at  Beaugency.  During  the  Franco-Prussian  War 
and  the  siege  of  Paris,  animal  vaccination  ceased.  In  November,  1873, 
Professor  Depaul  assures  Dr.  H.  A.  Martin,  of  Boston,  that  the  virus  car¬ 
ried  from  Paris  by  his  agent  in  1870,  was  the  last  to  have  left  the  city,  and 
that  during  the  siege  the  “stock”  was  lost.  The  animal  virus  employed  in 
Paris,  since  the  Franco-Prussian  War,  is  from  other  stock  discovered  since 
that  of  Beaugency.  (Report  on  Animal  Vaccination  by  Henry  Austin  Mar¬ 
tin,  M.  D.  Reprint  from  the  Transactions  of  the  Amerioan  Medical  Asso¬ 
ciation,  Boston,  1877,  p.  17.) 

There  are  two  principal  grounds  on  which  the  practice  of  vaccination 
from  the  heifer  has  been  advocated. 

1.  The  opinion  is  widely  though  not  universally  held,  that  the  results  of 
vaccination  from  arm  to  arm  are  not  such  as  they  used  to  be  during  the 
earlier  years  of  the  practice  of  vaccination  ;  in  fact,  that  by  repeated  human 
transmissions  the  virus  has  become  weakened,  and  that  the  pocks  produced 
by  the  introduction  of  lymph  which  has  passed  through  a  large  number  of 
human  beings  are  not  so  fine  or  so  perfect  as  those  which  result  from  the 
use  of  lymph  derived  recently  from  the  cow. 

2.  The  opinion  that  certain  human  diseases  may  be  propagated  together 
with  the  vaccine  when  vaccinations  are  performed  from  arm  to  arm. 

G-albiati  adduced  this  belief  as  his  reason  for  practicing  vaccination  from 
the  cow  j  arguing  that  on  vaccinating  the  cow  from  the  human  subject,  the 
vaccine  disease  alone  would  be  communicated  to  her,  the  other  morbid 
germs  which  might  be  introduced  with  it  remaining  without  effect.  He 
considered  apparently  that  in  practicing  retro- vaccination  he  as  it  were 
filtered  human  vaccine  from  all  human  contamination. 

The  publication  within  the  last  few  years  of  alleged  outbreaks  of 
syphilis  after  and,  as  is  stated,  as  the  result  of  vaccination  from  diseased 
subjects,  has  greatly  assisted  to  popularize  the  practice  of  animal  vac¬ 
cination.  They  not  only  made  a  deep  impression  upon  the  public  mind, 
but  determined  the  adoption  of  the  practice  by  some  distinguished  physi¬ 
cians. 

One  of  the  highest  living  authorities  on  vaccination,  M.  Depaul,  in  a 
report  to  the  Academie  de  Medccine,  which  attracted  much  attention  and 
gave  rise  to  much  angry  discussion,  expressed  his  views  upon  this  subject 
so  decidedly  that  nothing  was  logically  left  him  but  to  recommend  the 
entire  discontinuance  of  arm  to  arm  vaccination  and  the  use  of  animal 
vaccination  as  the  only  safe  method  of  propagating  the  disease. 

Dr.  Edward  C.  Seaton,*  in  his  elaborate  report  on  “so  called  animal 
vaccination,  in  France,  Belgium  and  Holland,  not  only  embodies  the  results 
of  the  careful  investigation  of  Dr.  Edward  Ballard,  upon  the  history  and 
practice  of  animal  vaccination  in  various  parts  of  Europe,  but  also  presents 
his  own  extended  and  elaborate  personal  observaf  ons  upon  European 
animal  vaccine  establishments. 


*  Twelfth  Report  of  the  Medical  Officer  of  the  Privy  Council,  London,  1870  p.  171-101 . 


406 


Spurious  Vaccination  :  Joseph  Jones ,  M.  D. 


Dr.  Seaton  thus  states  his  general  conclusions. 

“So  far,  then,  as  evidence  at  present  goes,  it  appears  quite  clear. 

(1 ) .  That  the  present  degree  of  success  attending  the  practice  of  animal  vaccination  is, 
in  comparison  with  the  success  attending  on  vaccination  from  arm  to  arm,  very  low, 
and  such  as  to  constitute  a  most  serious  drawback  to  its  use,  supposing  that  other  reasons 
were  deemed  sufficiently  strong  to  render  the  introduction  as  an  alternative  proceeding 
desirable. 

(2) .  That  much  training  and  experience  are  indispensable  to  the  attainment  of  even 
that  degree  of  success  which  at  present  attends  it. 

If  practicted  and  most  scrupulously  careful  vaccinatiors,  anxiously  endeavoring  to 
make  the  experiment  successful  and  neglecting  no  known  precaution  for  the  purpose, 
find  after  two  years  experience  that  in  vaccinating  direct  from  the  heifer  to  the  arm, 
they  are  obliged  in  one  eighth  of  these  cases  to  vaccinate  a  second  time  before  they  can 
produce  any  effect,  and  that  in  the  end  very  nearly  one  fourth  of  the  children  who  are 
infected  in  this  way  are  sent  out  with  that  imperfect  degree  of  protection  against  small¬ 
pox  which  is  afforded  by  onljT  one  or  two  vaccine  vesicles,  it  must  I  think  be  obvious 
that  by  the  adoption  of  such  a  practice  we  should  be  greatly  weakening  our  defense 
against  small-pox. 

The  chance  to  each  individual  of  a  full  protection  would  be  very  largely  diminished, 
and  the  danger  to  the  community  of  spreading  small-pox  greatly  increased  by  the  num¬ 
ber  of  half  protected  persons  thrown  upon  it.  We  should  be  going  back  in  fact  to  the 
state  of  things  which  from  other  causes,  existed  a  few  years  ago,  and  from  which  of  late 
years  so  much  has  been  done  to  rescue  us. 

The  large  quantity  of  lymph  which  would  be  available  at  short  notice  in  case  of  epi¬ 
demic  outbreaks  of  small-pox,  and  of  want  of  sufficient  supply  of  ordinary  lymph,  lias 
been  nut  forward  as  one  of  the  great  advantages  which  would  attend  the  use  of  animal 
vaccination.  Under  the  arrangement,  however,  now  in  force,  in  England,  deficiency  of 
lymph  supply  in  any  such  emergency  is  a  contingency  which  need  not  be  thought  of. 
And  if  there  be  a  time  when  it  is  important  that  the  lymph  employed  should  be  such  as 
can  be  depended  on  for  success,  that  it  should  strike  home  withou  t  failing,  it  is  surely  when 
persons  brought  for  vaccination  are  in  immediate  danger  of  contracting  small-pox.” 

My  experience  with  the  so  called  ubovine  matter ”  used  in  New  Orleans 
during  the  past  four  years,  corresponds  with  the  preceding  statement  of 
Dr.  Seaton. 

The  vaccine  matter  on  points  and  quills  and  crusts  furnished  by  the 
various  vaccine  farms  of  the  United  States,  has  not  given  universal  sat¬ 
isfaction  with  the  profession  on  account  of  the  vast  number  of  failures 
which  have  attended  its  use. 

These  failures  appear  to  have  been  referable  to  several  causes,  amongst 
which  we  may  mention. 

1.  The  abstraction  of  too  much  lymph  from  each  vesicle  in  the  cow.  In 
other  words  the  effort  to  supply  a  large  demand  and  secure  large  pecu¬ 
niary  profits  with  a  limited  supply  of  cow-pox  matter. 

A  careful  examination  of  many  of  the  points,  revealed  the  fact  that  the 
“ dried  lymph”  was  largely  composed  of  the  constituents  of  the  blood — 
many  colored  and  colorless  blood  corpuscles — albumen  and  fibrin. 

This  result  was  in  many  cases  due  to  the  usejof  the  bloody  serum  flowing 
from  the  injured  pocks. 

2.  Carelessness  in  the  selection  of  the  animals  vaccinated,  and  the  failure 
to  reject  all  inperfect  pocks. 

3.  Changes  m  the  infective  powers  of  the  cow-pox  matter,  consequent 
upon  tune,  heat  and  moisture. 

In  the  emergency  of  the  small-pox  of  1882  and  isS3  in  New  Orleans,  the 
sanitary  officers  of  the  Board  of  Health,  of  the  State  of  Louisiana,  have 
not  been  able  to  meet  the  issue  by  the  employment  of  bovine  matter  alone. 

Out  of  over  12,000  (twelve  thousand)  gratuitous  vaccinations  performed 
by  the  president  and  sanitary  officers  of  the  Board  of  Health,  of  the  State 
of  Louisiana,  during  the  past  four  years,  no  case  of  vaccinal  syphilis,  or  of 
serious  accident  has  been  reported.  The  vast  proportion  of  these  vaccina- 
1  ions  vere  perfor  ned  with  humanized  virus ;  and  in  all  cases  care  was  taken 
to  select  the  matter  from  healthy  subjects. 


Spurious  Vaccination:  Joseph  Jones.  M.  D. 


407 


GENERAL  CONCLUSIONS. 

From  the  vast  mass  of  matter  relating  to  vaccination,  including  the 
valuable  works  of  Jenner,  Pearson,  and  Woodville,  recorded  in  the  preced¬ 
ing  pages,  we  may  draw  the  following  practical  conclusions  : 

1.  The  practice  of  vaccination  carefully  performed  in  accordance  with 
the  rules  and  regulations  laid  doAvn  by  Edward  Jenner,  is  as  complete  a 
protection  from  small-pox  at  the  present  time  as  in  the  early  part  of  the 
nineteenth  century.  Millions  of  human  beings  have  been  preserved  from 
the  most  loathsome  and  destructive  of  modern  pestelinces  during  the  past 
eighty-tour  years  by  vaccination. 

2.  Without  vaccination,  the  application  of  steam  and  navigation  and 
land  travel  would  have,  during  the  past  fifty  years,  scattered  the  seeds  of 
small-pox  in  every  part  of  the  habitable  globe. 

Fortunately  for  mankind,  the  great  discovery  of  Jenner  was  announced 
before  the  application  of  steam,  and  the  revolution  of  commercial  and  mili¬ 
tary  operations. 

3.  The  practice  of  vaccination  has  not  impaired  the  strength  and  vigor 
of  the  human  race,  but  on  the  contrary  has  added  vastly  to  the  sum  of  hu¬ 
man  life,  happiness  and  health. 

4.  Variolous  inoculation  which  preceded  vaccination,  induced  a  compara¬ 
tively  mild  disease,  and  served  as  a  protection  against  subsequent  casual 
contagion  ;  but  it  multiplied  the  foci  of  contagion,  kept  perpetually  alive 
the  contagion  of  small-pox,  and  increased  the  fatal  ravages  of  this  disease 
amongst  mankind. 

5.  Asa  general  rule,  vaccination  in  itself  is  a  harmless  operation  5  and 
whilst  lessening  the  ravages  of  small-pox  it  has  not  had  the  effect  of  pro¬ 
moting  the  occurrence  of  other  fatal  maladies. 

G.  Whilst  the  protection  afforded  by  vaccination  against  small-pox  is 
neither  unconstitutional  nor  unlimited,  nevertheless  many  of  the  conditions 
upon  which  it  depends  are  under  the  control  of  mankind  For  the  majority 
of  persons  vaccinated  in  infancy  and  not  unusually  exposed  to  the  conta¬ 
gion  of  variola,  vaccination  serves  as  a  life-long  protection  against  attacks 
of  this  disease.  Experience  however  demonstrates  that  vaccination  in  in¬ 
fancy  is  not  an  absolute  protection  to  all  persons,  against  a  future  attack 
of  small  pox,  and  in  a  few  persons,  small-pox  has  happened  within  a  very 
short  period  of  time  after  vaccination.  Neither  is  small-pox  an  absolute  pro¬ 
tection  to  all  persons  against  a  recurrence  of  the  disease,  still  the  recurrence 
of  small  pox  is  a  much  more  rare  event  than  small-pox  after  vaccination. 
Post- vaccinal  small  pox  is  most  commonly  met  with  in  epidemic  seasons, 
or  under  circumstances  of  unusual  or  prolonged  exposure  to  contagion. 

7.  When  vaccination  fails  to  impart  absolute  protection  against  small¬ 
pox  contagion,  it  nevertheless  modifies,  in  the  majority  .of  instances,  the 
course  of  the  disease  and  renders  it  less  fatal.  The  protection  against  the 
contagion  of  small-pox  commences  from  the  time  that  the  areola  is  formed 
around  the  vaccine  vesicle. 

8.  A  large  number  of  persons,  vaccinated  in  infancy,  reacquire,  in  the 
progress  of  years,  the  power  of  developing  the  virus  of  small-pox  in  their 
systems;  the  breaking  of  the  protective  power  of  infant  vaccination  is  pro¬ 
gressive,  and  occurs  most  rapidly  during  the  period  of  most  active  bodily 
growth  from  infancy  to  puberty;  therefore,  revaccination  should  be  per¬ 
formed  about  the  age  of  fifteen,  or  at  any  time  when  small-pox  becomes 
prevalent. 

9.  The  production  of  a  perfect  or  imperfect  vaccine  disease,  and  the 
amount  of  protection  imparted  in  vaccination,  depends,  to  a  considerable 
extent,  upon  the  adoption  or  neglect  of  certain  precautions,  having  ref- 


408 


Spurious  Vaccination :  Joseph  Jones,  M.  I). 


erence  to  the  source  from  which  the  lymph. is  derived,  to  the  subject  vac¬ 
cinated,  and  circumstances  and  mode  in  which  the  operation  is  performed. 
The  opinion  is  held  by  many  that  the  vaccine  disease  is  a  less  perfect  and 
harmless  protection  against  small  pox  when  produced  by  the  inoculation 
of  virus  which  has  already  undergone  a  large  number  of  transmissions. 
Hence,  it  has  been  concluded  that  post-vaccinal  small-pox  would  occur 
more  rarely  if  lymph  directly  from  the  cow,  or  only  a  few  removes,  is  em¬ 
ployed. 

Without  doubt,  the  profession  should,  at  all  times,  seek  to  discover  cases 
of  cow-pox,  and  recurrence  to  the  original  source  of  vaccine  lymph  should 
be  had  whenever  practicable. 

10.  It  is  the  duty  of  municipal,  state  and  general  governments  to  regu¬ 
late  and  foster  a  correct  system  of  vaccination,  and  to  institute  and  sustain 
the  necessary  establishments  for  the  supply  to  all  citizens,  regardless  of 
condition  or  race,  supplies  of  pure  vaccine  matter,  derived  from  healthy  liu- 
liuman  beings,  or  from  animals  suffering  with  the  natural  cow-pox,  or  from 
a  system  of  inoculation  of  cow-pox  from  heifer  to  heifer,  or  repeated  and 
continuous  successions:  such  general,  municipal  and  state  regulations  should 
embrace  the  revaccination  of  all  persons  at  the  age  of  sixteen  years,  and 
such  persons  so  vaccinated  may  be  regarded  as  permanently  protected. 

11.  Vaccination  should  be  performed  by  experienced  physicians,  and 
with  every  attention  and  precaution  as  to  the  cleanliness  of  the  operator 
and  his  instruments,  and  the  freshness  and  purity  of  the  vaccine  matter. 

12.  The  experience  of  the  Confederate  medical  officers  during  the  recent 
American  civil  war,  1861-1865,  was  most  extensive  and  valuable,  and  tended 
to  establish  the  necessity  of  the  greatest  care  in  the  selection  and  mode  of 
propagation  of  the  vaccine  disease. 

The  Confederate  struggle  of  1861-1865  opened  a  new  field  in  the  history 
of  vaccination,  and  the  experience  thus  obtained  led  to  greater  care  in 
the  performance  of  the  operation  ;  but  the  results  of  this  war  in  liberating 
the  African  slaves  of  the  Southern  States,  necessarily  promoted  the  spread 
of  small-pox  amongst  an  ignorant  and  comparatively  helpless  class  sud¬ 
denly  elevated  to  the  rights,  responsibilities  and  license  of  almost  absolute 
freedom. 

When  the  colored  people  of  the  South  were  under  the  direction  and  con¬ 
trol  of  their  intelligent  white  masters,  small  pox  was  almost  unknown.  It 
is  apparent  from  the  results  of  the  prevalence  of  small-pox  since  the  war, 
amongst  the  colored  people,  that  the  municipal  police  and  state,  govern¬ 
ments  should  take  immediate  steps  to  adopt  all  the  necessary  statutes, 
rules  and  regulations  for  the  protection  of  the  colored  people  and  all  other 
citizens,  who  neglect  vaccination,  from  the  ravages  of  small-pox. 

13.  When  properly  conducted,  vaccination  is  never  the  medium  of  pro¬ 
pagating  small-pox ;  nor  is  there  any  reason  to  believe  that  scrofula  or 
tuberculosis  has  been  transmitted  by  this  process.  At  the  same  time  virus 
should  not  be  used  from  unhealty  individuals. 

14.  In  children  hereditarily  iufeeted  with  syphilis,  vaccination  hastens 
the  manifestation  of  the  already  existent ,  but  latent,  constitutional  taint ; 
and  many  cases  of  so-called  post-vaccinal  syphilis  are  traceable  to  the 
excitation  of  the  latent  disease  into  such  active  manifestations  as  will 
render  the  vaccine  matter  capable  of  transmitting  syphilis. 

When  vaccination  excites  symptoms  of  constitutional  syphilis,  in  one 
already  infected  with  the  poison  of  this  disease,  either  by  inheritance  or 
preceding  contagion — there  is  no  chancre  formed  at  the  place  ot  the  inser¬ 
tion  of  the  vaccine  virus.  But  when  syphilis  is  communicated  by  the 
operation  of  vaccination,  a  chancre  forms  at  the  point  where  the  vaccine 


Spurious  Vaccination  :  Joseph  Jones,  M.  D. 


409 


virus  was  introduced.  This  is  a  consideration  of  importance  in  tracing- 
vaccine  syphilis  to  its  origin  in  any  given  series  of  cases. 

15.  The  numerous  cases  recorded  demonstrate  that  constitutional  syphilis 
may  be  transmitted  by  contagion,  by  the  abnormal  secretions,  by  the  blood 
and  by  the  vaccine  lymph. 

The  vaccine  virus  and  the  syphilitic  virus  may  both  be  inoculated  at  the 
same  spot  and  by  the  same  puncture  of  the  vaccine  lancet,  and  in  such 
instance  both  viruses  may  take  effect,  the  vaccine  vesicle  running  naturaly 
through  its  several  stages,  and  being  succeeded  by  a  chancre  on  the  tall  of 
the  crusts. 

In  the  case  of  a  vaccinifer  constitutionally  infected  with  syphilis,  the 
danger  of  imparting  syphilis  with  the  vaccine  is  greatest  when  some  of 
the  blood  of  the  vaccinifer  lias  been  accidentally  mingled  with  the  lymph 
obtained  in  puncturing  the  vesicle.  At  the  same  time  in  vaccinating, 
syphilis  is  not  necessarily  imparted  to  the  person  vaccinated. 

1G.  Whilst  the  danger  of  syphilitic  inoculation  exists,  when  vaccination 
is  carelessly  performed ;  the  practical  bearing  of  this  fact,  however,  has 
been  greatly  exaggerated;  for  in  the  hands  of  the  most  experienced  physi¬ 
cians  and  surgeons  in  Europe  and  America,  it  is  a  danger  practically  so  in¬ 
significant  as  not  to  detract  materially  from  the  value  of  arm  to  arm  vac¬ 
cination  as  a  popuiar  practice  of  general  applicability. 

It  is  small  pox  and  not  syphilis  which  threatens  our  people  with  destruc¬ 
tion,  and  which  is  perpetually  knocking  at  their  gates.  In  the  Mississippi 
Valley  especially  with  its  teeming  millions  of  rapidly  increasing  colored 
people — the  danger  from  syphilitic  inoculation  under  a  properly  conducted 
system  of  vaccination  is  almost  inappreciable,  whilst  the  danger  of  small¬ 
pox  contagion  is  perpetual. 

Good  physicians  and  wise  legislators  should  guard  the  public  welfare 
from  the  disastrous  and  murderous  effects  of  the  silly  reasoning  of  illogical 
detractors,  the  exaggerated  fears  of  the  timid,  or  the  subtle  insinuations 
of  selfish  quackery. 

17.  Even  if  the  danger  of  syphilitic  contamination  by  vaccination  was 
greater  than  it  really  is,  the  adoption  of  the  following  precautions  on  the 
part  of  the  vaccinator,  the  inoculation  of  syphilis  in  vaccination  would  be 
almost  an  impossible  event. 

(a) .  Lymph  for  vaccination  should,  as  a  rule,  not  be  taken  from  an 
adult  person.  The  chances  are  greater  of  meeting  with  a  syphilitic  vaccin¬ 
ifer  in  adults  than  in  children. 

As' a  rule,  lymph  should  not  be  taken  from  an  infant  under  three  months 
of  age,  since,  if  any  syphilitic  taint  exists,  it  will,  most  probably,  have  de¬ 
clared  itself  during  this  period. 

( b ) .  Before  taking-  lymph,  a  careful  examination  should  be  made  of 
the  surface  of  the  body  of  the  vaccinifer,  of  the  mouth,  genitals  and  anus, 
and  every  infant  should  be  rejected  which  is  manifestly  out  of  health  or 
presents  an  eruptive  or  morbid  appearance  anywhere. 

Inquiry  should  be  made  into  the  health  of  the  parents  and  nurse  and 
the  least  suspicion  of  syphilis  in  either  or  in  the  child  itself  should  lead  to 
the  rejection  of  the  vaccinifer. 

(c .)  The  hands  and  person  and  the  lancet  of  the  vaccinator  should  be 
scrupulously  clean;  the  lancet  should  be  strictly  used  for  vaccination  alone, 
and  should  never  be  employed  for  opening  abscesses  or  other  surgical 
operations  ;  and  the  lancet  should  be  cleansed  and  wiped  perfectly  clean 
after  each  vaccination.  The  use  of  an  unwiped  lancet,  with  the  blood  of 
the  vaccinated  child  or  person  upon  it,  is  not  merely  careless  and  un- 


410 


Spurious  Vaccination :  Joseph  Jones ,  M.  D. 


cleanly,  but  if  syphilis  exists  in  any  one  of  the  vaccinated,  it  may  be 
transmitted  through  the  blood  on  the  point  of  the  lancet, 

fd).  In  taking  lymph,  great  caution  should  be  observed  in  opening  the 
vesicle,  so  as  not  to  draw  any  blood  ;  should  blood  be  accidently  drawn,  the 
vesicle  should  be  abandoned,  the  lancet  cleaned,  and  a  new  vesicle  opened. 
Itisbestto  abstain  from  vaccinating  more  children  from  one  vesicle  than  can 
be  conveniently  done  with  the  lymph  supplied  from  the  first  punctures 
made  into  the  surface.  Lymph  should  not  be  taken  from  a  vesicle  after 
the  areola  is  established,  or  from  one  irritated  or  damaged.  Parents  and 
nurses  should  be  warned  against  moistening  the  punctured  spots  or  vesi¬ 
cles,  when  they  arise  with  saliva,  and  also  against  applying  old  linen  to  the 
spots  unless  previously  well  washed. 

(e).  No  child  should  be  vaccinated  whose  parents  or  nurse  are  known  at 
the  time  to  be  the  subject  of  any  primary  or  secondary  manifestations  of 
syphilitic  disease,  unless  removed  temporarily  from  the  influence  of  con¬ 
tagion. 

The  vaccinator  should,  at  all  times  and  under  all  circumstances,  retain  a 
due  sense  of  the  responsibility  which  attaches  to  the  act  of  vaccination,  as 
well  as  to  all  others  of  a  professional  character. 

JOSEPH  JONES,  M.  D., 

156  Washington  street,  Fourth  District. 
New  Orleans,  La.,  March  4,  1884. 


VTC 

588 

JTT 

188U 


Jones , 

Contagious 

diseases 


